COLLEGE  OF  OSTEOPATHIC   PHYSICIANS 
AND  SURGEONS  •  LOS  ANGELES,  CALIFORNIA 


Practical 
Electro-Therapeu  tics 


V       BY 

Al 

FRANKLIN  B.  GOTTSCHALK,  M.  D. 

Professor  of  Diseases  of    Children    at  Jenner   Medical    College; 
Attending     Physician     German  -  American     Hospital; 
Assistant  to  Chair  of  General  Medicine    Chi- 
cago    Polyclinic ;     Member     Ameri- 
can    Medical     Association  ; 
Chicago     Medical 
Society, 
etc. 


REVISED  1908  EDITION 

WITH  SPECIAL  SECTION    ON 

VIBRATORY  STIMULATION 


PUBLISHED   BY 

FRANK  S.  BETZ  Co. 

HAMMOND,    IND. 
1908 


COPYRIGHT  1904,  BY 
FRANKLIN  B.  GOTTSCHALK,  M.  D, 


PREFACE. 

This  book  contains  a  concise  presentation  of  the  most 
important  modes  of  treating  patients  by  means  of  electricity, 
a  knowledge  of  which  the  busy  practitioner  may  acquire 
more  permanently  through  good  illustrations  than  through 
the  most  elaborate  descriptions.  It  has  been  written  with  the 
idea  of  bringing  forth  facts,  and  facts  only,  for  a  clear  com- 
prehension of  the  topic  under  discussion. 

The  author  is  a  thorough  believer  in  drugs,  hygiene  and 
diet,  but  believes  that,  by  the  application  of  the  principles 
here  laid  down,  results  may  be  obtained  which  appear  mar- 
velous to  one  not  familiar  with  their  application.  The  com- 
bined effect  of  drugs,  electricity,  the  electric  light  baths  and 
vibratory  stimulation  seems  at  times  almost  magical  in  the 
instant  relief  brought  to  the  patient. 


27036 


INTRODUCTION. 

While  our  conception  of  the  nature  of  electricity  is  largely 
theoretical,  we  by  no  means  lack  positive  knowledge  con- 
cerning its  actions  and  the  laws  that  govern  them.  Great 
progress  has  been  made  in  utilizing  this  agent  in  the  arts, 
and  by  means  of  electro-therapeutics  maladies  are  now  cured 
that  were  formerly  not  amenable  to  treatment. 

There  is  only  one  kind  of  electricity,  no  matter  how  gen- 
erated, but  its  actions  vary  widely  according  to  the  current 
and  instrument  used  in  employing  it. 

Investigators  have  demonstrated  that  both  animal  and  veg- 
etable life  are  due  to  and  dependent  upon  electric  conditions, 
and  it  is  more  than  likely  that  the  organs  of  active  nutrition 
give  rise  to  electric  currents.  It  is  also  true  that  animal 
organs  and  tissues  are  modified  and  influenced  by  electricity. 

There  are  many  reasons  why  the  work  of  the  nervous 
system  should  be  compared  with  the  complex  workings  of 
an  electrical  battery.  In  health  the  nerves  are  all  in  a 
state  of  vibration,  due  in  all  probability  to  the  electrical 
currents  which  traverse  the  body  in  every  direction.  When 
it  loses  its  vibratory  function,  death  and  degeneration  ensue. 
The  various  nerves  respond  to  different  vibrations.  The 
optic  nerve  responds  to  very  rapid  vibrations,  while  large 
waves  stimulate  the  nerves  of  the  ear,  etc. 

Electricity  has  become  the  mainstay  of  the  neurologist 
both  in  diagnosis  and  treatment.  It  is  one  of  his  most 
important  tools.  The  more  familiar  we  are  with  its  mani- 
festations, the  more  we  recognize  its  adaptation  to  the 
requirements  of  a  disordered  physiological  condition.  By 
means  of  electricity  we  frequently  get  a  knowledge  of  the 
probable  duration  and  curability  of  certain  diseases,  which 
we  never  could  obtain  in  any  other  way.  The  value  of  this 
is  evident,  when  we  .reflect  that  the  correct  determination  of 
the  polar  responses  of  a  muscle  of  a  limb  may  mean  a  verdict 
of  cerebral  disease  on  the  one  hand,  or  a  trifling  pressure 
paralysis  on  the  other.  Again  it  is  of  great  medico-legal 
value  in  determining  the  presence  or  absence  of  lesions  due 
to  accidents. 


6  INTRODUCTION 

For  the  intelligent  use  of  electricity  it  is  absolutely  neces- 
sary to  know  the  elementary  principles  and  have  a  clear 
knowledge  of  the  physiological  action  of  the  different  currents 
on  the  human  system.  If  the  nature  of  electricity  is  only 
imperfectly  understood  it  is  ridiculous  to  attempt  to  use  it, 
for  being  a  potent  agent  it  may  do  much  harm  if  not  prop- 
erly employed.  It  is  better  not  to  employ  it  at  all  than  to 
use  it  without  a  clear  knowledge  of  its  physiological  action, 
for,  like  strychnine,  it  may  be  valuable  if  given  when  indica- 
ted and  in  proper  dosage,  and  vice  versa. 

By  its  careful  study  and  application  many  ailments  may 
be  relieved  and  heroic  operation  will  frequently  become 
unnecessary. 

If  we  wish  mechanical  effects  we  select  the  currents  of 
alternation  with  a  to-and-fro  motion.  For  a  chemical  effect  a 
current  of  considerable  amperage  is  necessary,  while  physio- 
logical effects  may  be  excited  by  every  possible  manifestation 
of  electricity. 

Idiosyncrasies,  here  as  elsewhere,  play  their  part.  Some 
patients  react  better  to  one  form  of  electricity  than  to 
another;  while  other  patients,  suffering  from  the  same 
apparent  pathological  condition,  and  for  no  apparent  reason, 
react  better  to  other  forms. 

The  large  majority  of  patients  who  apply  for  electric 
treatment  are  chronic  cases  and  require  chronic  treatments. 
Relapses  are  apt  to  occur  just  the  same  as  those  following 
surgical  or  medical  treatment. 

The  source  of  many  disorders  is  oftentimes  found  outside 
of  the  boundaries  of  the  structure  affected,  and  the  thera- 
peutic measures  to  be  successful  must  be  directed  so  as  to 
control  and  correct  the  beginnings  of  the  morbid  processes. 

The  nervous  system  is  made  up  of  individual  elements 
termed  neurons,  together  with  neuroglia,  connective  tissue, 
blood-vessels  and  lymphatics;  and  diseases  that  pertain  to 
it  must  affect  one  or  more  of  these  structures.  These  tissues 
are  not  many,  nor  are  the  pathological  processes  that  arise 
in  them  numerous.  According  to  the  location  or  function 
of  the  tissue  involved,  we  have  a  large  variety  of  clinical 
pictures  and  it  is  only  proper  to  approach  these  troubles 
from  a  physiological  and  anatomical  rather  than  from  a 
symptomatic  standpoint. 

The  author   believes   that  if  the  elementary  principles  of 


INTRODUCTION  7 

electro-therapeutics  are  thoroughly  understood  the  physician 
will  be  able  to  make  the  applications  that  are  necessary  with- 
out more  definite  explanations  than  are  found  in  this  work. 

Our  physiology  tells  us  that  to  keep  an  organ  in  perfect 
repair  we  must  have  a  perfect  circulation.  Disease  really 
means  a  stagnation  of  the  circulation  in  that  particular  part. 
A  congestion  anywhere  is  a  detriment  to  the  organ  concerned. 
Our  bodies  are  run  on  strictly  business  principles.  Money 
hoarded  is  of  no  value.  It  only  increases  in  the  channels 
of  trade,  and  blood,  like  money,  is  of  no  value  unless  in  circu- 
lation. We  can  only  build  up  our  vitality  by  using  the 
means  at  our  disposal  just  as  does  a  business  concern.  We 
can  only  distribute;  we  can  create  nothing  of  the  human 
principle,  except  out  of  the  surplus.  Surplus  means  growth. 

There  is  enough  energy  going  to  waste  in  the  healthy 
mortal  to  build  up  a  helpless  organ.  Electricity  affords  us 
a  means  of  directing  this  surplus  energy  to  the  diseased  por- 
tion of  the  body. 

Of  all  physical  measures  used  in  therapeutics,  there  is  none 
that  permits  the  use  of  suggestion  along  with  it  so  well  as 
does  electricity.  The  patient  is  usually  resting  quietly  while 
the  current  is  passing,  with  the  mind  in  a  perfectly  passive 
and  receptive  condition.  Instructions  in  regard  to  habit, 
physical  exercise  and  diet,  being  daily  and  frequently 
repeated,  are  adopted  as  fixed  thoughts  and  not  easily  for- 
gotten. These  are  of  much  value,  as  it  brings  about  the 
earnest  co-operation  of  the  patient. 


The  Pope-Massey  Galvanic  and  Faradic  Wall_Cabinet. 


ELECTRICITY  AND  ITS  GENERATION. 

Recent  research  has  proven  that  electricity  pervades  all 
space,  possesses  no  inertia  and  moves  without  friction.  It 
transmits  energy  and  motion.  Light,  heat,  electricity  and 
magnetism  arc  all  transmitted  through  space  by  some  active 
condition  of  cther,eithcr  longitudinal  or  horizontal  vibrations. 

We  can  not  produce  electricity  any  more  than  we  can 
produce  a  current  of  water,  but  ve  can  produce  pressure 
somewhere  in  the  circuit  and  thus  cause  it  to  be  set  in 
motion,  and  are  able  to  regulate  its  flow. 

Electricity  may  be  compared  with  the  flow  of  water  in  pipe 
which  connects  two  reservoirs  containing  water  at  different 
levels.  Water  flows  from  higher  to  the  lower  level.  The 
greater  the  difference  in  levels  the  greater  the  pressure  and 
consequent  flow  of  water.  Water  flows  faster  through  a 
short  than  through  a  long  small  pipe. 

Similarly,  the  greater  the  pressure  or  electro-motive  force 
the  stronger  the  current,  and  the  greater  the  resistance  of 
the  circuit,  the  less  the  current. 

The  commercial  current,  due  to  its  almost  unvarying 
uniformity,  is  the  most  desirable  to  those  who  have  access 
to  it.  It  can  be  used  for  the  purposes  of  galvanism, 
faradism,  cautery  and  sinusoidal.  When  this  current  is 
not  available  the  current  may  be  produced  by  decomposi- 
tion, or  the  conversion  of  chemical  energy  into  electrical 
energy. 

It  has  been  proved  that  when  two  dissimilar  substances 
are  placed  in  contact,  one  of  them  always  assumes  the  posi- 
tive and  the  other  the  negative  condition,  though  the  amount 
of  difference  may  be  small  and  difficult  to  measure.  Placing 
copper  and  zinc  in  contact  develops  a  difference  in  potential 
easily  detected.  The  same  results  hold  true  if  the  plates  are 
slightly  separated  and  immersed  in  a  saline  or  acidulated 
solution  (voltaic  cell).  The  exposed  ends  of  the  plates  are 
now  charged  to  different  degrees  of  electrical  potential,  one 
plate  being  higher  than  the  other.  When  the  exposed  ends" 
are  connected  by  a  conducting  wire  the  difference  tends  to 
be  equalized  by  a  rush  from  one  pole  to  the  other,  its  passage 


10  PRACTICAL    ELECTRO-THERAPEUTICS. 

being  through  the  liquid.  In  passing  through  the  liquid, 
certain  chemical  changes  take  place.  These  in  turn  cause 
a  new  difference  in  potential,  and  follow  one  another  with 
great  rapidity,  in  fact  too  fast  to  be  distinguished,  appearing 
to  be  continuous.  This  equalizing  flow,  constantly  taking 
place,  is  known  as  the  direct  current.  It  only  becomes  con- 
tinuous when  the  difference  in  potential  is  maintained  and  no 
device  is  employed  to  interrupt  it. 

The  chemical  compound  or  solution  which  undergoes 
decomposition  when  traversed  by  an  electrical  fluid  is  known 
as  an  electrolyte. 

The  polarity  of  that  end  of  the  plate  which  is  acted 
upon  by  the  electrolyte  is  always  of  opposite  sign  to  its 
terminal,  as  seen  in  the  illustration.  Whenever  a  con- 
nection between  the  exposed  ends  is  broken  the  action 


Voltaic  Cell. 

ceases  until  they  are  again  connected.  In  any  voltaic  cell 
the  element  acted  upon  by  the  electrolyte  is  the  generating 
plate  and  its  electrode  is  always  the  negative. 

The  current  flows  from  the  higher  to  the  lower  level.  The 
high  point  is  always  the  anode  or  positive,  and  the  low  point 
is  always  the  cathode  or  negative. 

Within  the  cell  the  zinc  is  the  positive  element.  The 
current  flows  from  it  to  the  carbon,  but  outside  of  the  fluid 
this  is  reversed,  the  carbon  terminal  being  the  positive  and 
the  zinc  the  negative  pole. 

The  larger  the  surface  of  carbon  and  zinc  exposed  to  the 
action  of  the  excitant  the  greater  the  energy  developed. 
The  decomposition  taking  place  at  the  zinc  makes  it  the 
generating  plate.  The  positive  electricity  generated  there, 
flowing  through  to  the  carbon,  which  is  of  lower  potential, 
is  carried  out  of  the  cell  through  the  conducting  wire. 


PRACTICAL    ELECTRO-THERAPEUTICS. 


11 


It  is  not  an  easy  matter  to  select  the  proper  cells  for  medi- 
cal purposes;  portable  dry  battery  cells  are  preferred  by 
some,  but  they  have  a  distinct  disadvantage,  because  when 
exhausted  they  must  be  replaced  by  new  cells.  For  office 
work  those  cells  using  a  saturated  solution  of  ammonia 
chloride  are  to  be  preferred,  as  the  elements  may  remain  in 
the  fluid  and  do  service  for  a  long  time  and  can  be  placed 
in  closet  or  basement.  In  the  cells  using  bichromate  of  soda 
and  sulphuric  acid,  the  elements  must  be  removed  from  the 
fluid  when  the  battery  is  not  in  use,  as  zinc  is  consumed  as 


Different  Varieties  of  Galvanic  Cells. 

long  as  it  is  immersed.  The  sulpho-chromic  battery  is 
portable,  but  the  fluid  should  be  carried  in  a  separate  recep- 
tacle to  prevent  its  splashing  over. 

Battery  Solution — 

Bisulphate  of  mercury 54  pound. 

Bichromate  of  soda 1  pound. 

Add  two  quarts  of  water — stir  and  add  one  quart  of  com- 
mercial sulphuric  acid,  pouring  the  acid  in  slowly.  Add 
enough  water  to  make  one  gallon,  and  set  aside  to  cool. 
Used  hot  it  destroys  the  zincs  very  rapidly. 


12  PRACTICAL    ELECTRO-THERAPEUTICS. 

When  communication  is  established  between  the  elements 
in  the  fluid,  large  quantities  of  hydrogen  bubbles  collect 
around  the  carbon  element,  neutralizing  the  original  flow  of 
current.  The  larger  the  carbon  surface  the  longer  it  takes 
to  cover  it  with  hydrogen.  A  cell  in  this  condition  is  said 
to  be  polarised.  It  is  of  utmost  importance  to  remove 
this  hydrogen  either  by  mechanical  or  chemical  means.  The 
chemical  must  be  one  with  which  the  nascent  hydrogen  com- 
bines and  is  one  usually  rich  in  oxygen. 

When  acids  enter  into  the  composition  of  an  electrolyte 
there  is  apt  to  be  trouble  on  account  of  tendency  to  oxidize 
the  metallic  surface  connected  with  the  cell.  All  oxides  are 
poor  conductors  and  should  be  cleaned  with  a  piece  of  emery 


Portable  Galvanic  'and  Faradic  Battery. 

cloth.  Contact  surface  must  be  free  from  dust  and  be 
bright. 

The  zinc  must  be  amalgamated  to  prevent  this  local  action. 
Iron  must  be  separated  from  the  zinc  and  made  harmless. 
Before  amalgamating,  the  zinc  must  be  dipped  in  an  acid 
bath,  which  removes  impurities  from  the  surface;  then 
mercury  is  rubbed  in  with  a  cloth  or  a  piece  of  galvanized 
iron,  and  when  finished  should  be  bright  as  silver.  It  is  a 
peculiarity  of  this  amalgam  that  it  does  not  leave  the  zinc 
when  the  latter  dissolves,  but  immediately  attaches  itself  to 
fresh  portions  of  the  same.  If  a  hissing  noise  is  heard  when 
the  zinc  is  placed  in  the  electrolyte  it  signifies  that  the  zinc 
needs  re-amalgamation. 

A  storage  battery  is  one  in  which  certain  materials  are  so 


PRACTICAL    ELECTRO-THERAPEUTICS. 


13 


arranged  that  when  a  current  is  passed  through  it,  they 
store  up  energy  (not  electricity)  in  a  chemical  form.  This 
energy  can  be  reproduced  as  an  electric  current.  They  are 
usually  so  constructed  as  to  maintain  a  current  for  a  consid- 
erable length  of  time. 

The  manner  of  connecting   the  cells  together  depends   on 


Giant  Portable  Galvanic  and  Faradic  Battery. 

the  kind  of  work  required.  In  treating  the  human  body, 
which  offers  considerable  resistance,  our  desire  is  to  increase 
the  voltage — twenty  volts  for  the  slightest  current  and 
about  one  hundred  volts  for  the  more  heavy  current.  This 
pressure  may  be  obtained  by  connecting  the  cells  in  series, 
connecting  the  unlike  elements  of  the  cells,  as  per  illustration. 


14 


PRACTICAL    ELECTRO-THERAPEUTICS. 


For  instance,  from  forty  cells  of  one  volt  each  we  have  a 
pressure  or  push  power  of  forty  volts,  or  as  many  cells  as 
we  have  in  the  circuit.  Sixty-six  cells,  of  a  volt  and  one- 
half  each,  give  one  hundred  volts.  All  the  cells,  thus  con- 
nected in  series,  will  not  give  current  enough  to  heat  an 
ordinary  cautery  knife,  because  we  can  not  obtain  more 


Cells  Connected  in  Series. 

current  than  from  a  single  cell,  its  output  being  limited  to 
its  own  internal  resistance.  If,  however,  this  arrangement 
is  reversed  we  have  an  increased  quantity  of  current,  or  as 
many  amperes  as  cells,  and  but  one  volt  of  pressure.  This 
internal  resistance  is  overcome  by  connecting  the  cells  in 


Cells  Arranged  in  Parallel. 


parallel,  that  is,  all  the  carbons  are  connected  together  as 
the  one  positive  pole  and  all  the  zincs  as  the  negative, 
practically  making  them  one  enormous  cell  many  times 
larger  than  the  original,  just  the  same  as  increasing  the 
cell  thirty,  forty  or  fifty  times,  according  to  the  number  of 


PRACTICAL    ELECTRO-THERAPEUTICS.  15 

cells  used.     This  gives  us  the  desired  amperage,  but   a  very 
low  voltage. 

A  battery  works  best  when  the  internal  and  external 
resistances  are  the  same.  If  the  resistance  is  doubled  the 
amperage  is  halved  and  half  of  its  power  is  spent  in  the 
battery. 

ESSENTIALS. 

Though  our  knowledge  of  the  nature  of  electricity  is 
limited  we  can  measure  it  and  control  it. 

A  coulomb  is  the  measure  of  quantity,  the  same  as  a  gallon 
is  the  measure  for  water.  The  use  of  this  term  is  very 
limited  in  electro-therapeutics.  A  millicoulomb  (one  one- 
thousandth  of  a  coulomb)  is  the  unit  of  quantity  consumed 
in  a  medical  current. 

Amperage. — By  amperage  we  mean  the  rate  of  flow. 
An  ampere  is  the  unit  of  current  strength  flowing  through 
water,  which  will  liberate  0.0000105  grams  of  hydrogen  in 
one  second. 

By  voltage  we  mean  the  difference  in  the  electrical  level, 
as,  for  instance,  in  placing  two  tanks  filled  with  water, 
connected  by  a  tube,  on  different  levels.  It  is  the  force  or 
push  power.  The  human  skin  offers  high  resistance  to 
electricity.  With  the  ordinary  sponge  disk  thirty  volts  are 
necessary  to  force  a  current  into  the  tissues.  The  larger 
the  quantity  of  electricity  the  less  resistance  is  offered.  As 
only  a  certain  quantity  of  electricity  can  be  forced  through 
each  square  inch  of  surface  with  a  given  number  of  cells, 
the  number  of  cells  must  either  be  increased  or  the  area  of  the 
electrode.  A  large  electrode  should  be  used  where  a  large 
current  with  little  pain  is  desired.  The  resistance  varies  in 
different  parts  of  the  body  according  to  the  texture  of  the 
skin.  Tissues  underlying  the  fascia  are  fairly  good  con- 
ductors. 

An  ohm  is  the  resistance  offered  to  the  flow  of  current 
by  a  copper  wire  one-twentieth  of  an  inch  thick  and  250 
feet  long.  A  current  can  not  flow  through  any  conductor 
without  losing  some  of  its  pressure.  The  current  is  always 
reduced  by  the  resistance  of  the  conductor  through  which  it 
flows,  determined  by  the  substance  of  which  this  conductor 
is  made.  Length  of  wire  increases  the  resistance,  while 
thickness  of  wire  decreases  it,  just  as  the  small  pipe  will 


16  PRACTICAL    ELECTRO-THERAPEUTICS. 

carry  less  water  than  a  larger  one.  To  illustrate:  In  a 
fountain  syringe  full  of  water  this  pressure  at  the  nozzle 
may  be  compared  with  the  voltage,  the  pressure  depending 
on  the.  length  of  the  tube  and  the  height  at  which  the  bag 
hangs  above  the  point  of  the  nozzle.  The  longer  and  smaller 
the  tube  the  greater  the  resistance;  likewise,  the  longer 
and  thinner  the  conducting  wire  the  greater  the  resist- 
ance. Just  as  a  pipe  with  a  large  lumen  decreases  friction, 
so  a  thicker  wire  decreases  the  resistance  of  the  wire. 

Ohm's  Low. — The  strength  of  the  current  passing  through 
any  part  of  a   circuit   varies   directly  as   the  difference  of 


Milliamperemeter. 

potential  between  the  elements,  and  inversely  as  the  resist- 
ance of  the  circuit  itself. 

A  watt  is  the  unit  of  power  and  is  obtained  by  multiply- 
ing the  volts  by  the  amperes  in  a  given  circuit.  Whether  the 
cells  are  connected  in  parallel  or  in  series,  the  amount 
of  work  done  in  each  case  will  be  equal,  only  differing  in 
kind. 

The  milliamperemeter  is  used  to  gauge  the  amount  of  the 
current  passing  through  the  patient.  The  sensation  of  the 
patient  is,  as  a  rule,  not  a  guide  to  deep  therapeutic  action 
in  the  majority  of  cases.  A  current  comfortable  to  the  skin 
may  become  very  uncomfortable  over  an  eruption  or  abrasion 


PRACTICAL    ELECTRO-THERAPEUTICS. 


17 


underneath  the  electrode.  The  current  passing  into  these 
spots  at  an  uncomfortable  rate  causes  pain  and  frequently 
electrolysis.  Therefore,  when  a  current  of  electricity  is  being 
applied,  these  eruptions  or  abrasions  should  either  be  avoided 
or  covered  by  means  of  collodion,  adhesive  plaster,  rubber 
tissues  or  vaseline. 

A  rheostat  is  an  instrument  used  to  interpose  resistance 
to  the   passage  of  current,    and   gives  us  a  means  whereby 


Rheoitat. 

the  current  may  be  increased  or  decreased  gradually,  without 
the  uncomfortable  shock  to  the  nerves  unavoidable  without 
its  use. 

In  therapeutic  work  it  should  permit  the  gradual  and  gentle 
admission  of  a  current  after  the  electrodes  are  in  place,  up 
to  the  .strength  and  voltage  required,  maintaining  it  without 
fluctuation,  and,  when  work  is  done,  permitting  a  gentle 


Rheotome. 

and  gradual  withdrawal  of  the  current.  The  graphite 
rheostat  is  largely  used  for  electro  -  therapeutic  work; 
there  is,  however,  one  principal  objection  to  it.  It  is 
really  not  a  current  selector  in  its  true  sense,  but  more 
or  less  of  a  volt  selector.  Energy  resisted  is  converted 
into  heat,  and  heat  effects  the  graphite  and  carbon  of  which 
this  rheostat  is  composed  by  decreasing  its  resisting  power. 
This  compels  the  operator  to  be  on  the  lookout,  as  his 

2 


18  PRACTICAL    ELECTRO-THERAPEUTICS. 

resistance  needs  readjustment  while  in  use.  Using  a  high 
resistance  wire  coil  with  an  established  known  resistance  in 
the  main  circuit,  will  give  us  a  definite  and  known  amount 
of  voltage. 

For  cautery  work  the  rheostat  must  have  a  small  resistance 
and  a  large  current-carrying  capacity.  It  is  usually  com- 
posed of  windings  of  German  silver  wire. 

A  rheotome  consists  of  a  wheel,  which  rotates  at  a  given 
speed,  closing  and  opening  the  circuit  at  regular  intervals, 
which  may  be  varied  as  to  length  of  time. 

As  a  rule,  portable  batteries  have  no  meters;  it  is  best  to 
insert  one  in  the  circuit;  a  graphite  rheostat  may  also  be 
attached  to  control  the  current. 

The  materials  used  as  electrodes  must  be  good  conductors 


Portable  Milliamperemeter  and  Rheostat. 

of  electricity,  the  heat  conductivity  and  electrical  conductivity 
of  substances  being  equal. 

Water  passes  with  difficulty  through  a  pipe  filled  with  sand, 
stones,  etc.,  but  very  easily  through  large,  clear  pipe.  Thus 
a  wire  of  poor  conducting  material  offers  great  resistance 
to  passage  of  current,  but  a  good  conductor  of  large  cross 
section  offers  little  resistance. 

With  low  pressure  currents,  such  as  the  galvanic  and 
faradic,  it  is  essential  that  good  contact  be  made  between  any 
two  parts  of  the  circuit,  for  electricity  has  very  slight  power  to 
jump  through  the  air.  Though  the  human  body  is  composed 
of  moist  tissue,  it  is  surrounded  by  an  insulating  envelope 
of  dry  skin,  which,  together  with  the  slight  layer  of  air,  offers 
a  great  deal  of  resistance  to  the  current  of  electricity. 
Hence  it  is  necessary  that  the  electrode  covering  should  be 
moist  and  thus  render  both  itself  and  t!ie  cuticle  better  con- 


PRACTICAL    ELECTRO-THERAPEUTICS. 


19 


ductors.  Deep  penetration  is  the  prime  need  for  a  well- 
moistened  electrode  covering.  Moist  absorbent  cotton  is 
easily  applied  and  renewed.  Well-moistened  sculptors'  clay 
may  be  used  when  a  large  abdominal  pad  is  desired  to 
transmit  a  large  current  with  a  small  sensation  and  local 


Abdominal  Electrodes. 

resistance  at  this  spot.     If  thoroughly  adhesive  and  accurately 
in  contact  it  possesses  advantages  over  other  materials. 

A  flexible  cord% composed  of  fine  strands  of  wire  is  used  as 
a  conductor  for  the  electricity,  and  as  the  strands  making  up 
this  cord  are  frequently  broken,  they  move  apart,  causing 
the  current  to  reach  the  body  in  fits  and  jerks;  hence  they 


Carbon  Electrode. 

should  be  frequently  examined  as  to  their  conductivity. 
Imperfect  contact  at  the  binding  posts,  due  to  corrosion, 
also  interferes  with  the  conduction  of  the  current. 

Electrodes  must  be  made  of  substances  not  easily  corroded 
by  the  current.  Oxygen  and  chlorine  set  free  in  the  vicinity 
of  the  positive  pole  attack  the  baser  metals  and  form  com- 


20  PRACTICAL    ELECTRO-THERAPEUTICS. 

pounds  with  them.  When  it  is  desired  to  avoid  this  secondary 
action  of  the  current,  a  carbon  electrode  may  be  used. 

The  carbon  electrode  is  made  to  fit  snugly  against  the 
insulated  shaft,  which  is  penetrated  by  a  brass  or  copper 
rod.  It  is  intended  for  use  with  the  positive  pole.  Though 
it  may  be  used  with  the  negative  pole,  it  softens  the  carbon 
and  loosens  the  connection  with  the  metallic  rod.  It  is 
covered  with  a  thick  layer  of  cotton  wrapped  neatly  and 
compactly  about  it.  The  carbon  is  first  dipped  in  water 
and  then  by  rotary  motion  of  the  handle  the  cotton  held  in 
hand  is  twisted  about  the  ball.  It  must  be  well  moistened 
and  soaped  before  use. 

Gold,  platinum  and  irido-platinum  do  not  readily  enter 
into  composition  with  oxygen  and  chlorine.  Therefore,  steel 
instruments  heavily  plated  will,  for  a  time,  serve  the  same  pur- 


Sponge  Electrodes. 

pose  as  those  made  entirely  of  the  more  expensive  metal. 
Copper,  electrodes  of  copper,  zinc,  etc.,  should  be  of  as  pure 
metal  as  possible  and  the  surface  brightly  polished  before 
each  treatment.  When  we  wish  to  use  mercury,  a  copper 
or  zinc  electrode  is  dipped  into  an  amalgamating  fluid  and  is 
ready  for  use  after  a  little  rubbing  with  a  clean  cloth  to 
remove  the  excessive  acid. 

Thin  sheets  of  tin  or  plates  of  malleable  metal  will  be 
found  serviceable  in  applying  electricity  to  irregular  con- 
tours, as  joints,  etc.  When  metals  used  for  active  electrodes 
corrode  underneath  the  covering,  the  substance  thus  formed 
accumulates  on  the  surface  of  the  electrode  and  may  irritate 
the  skin,  or  may  even  be  conveyed  into  the  tissues  and  there 
produce  undesired  local  medication. 

The  sponge  electrode  should  be  well  moistened  with  a 
bicarbonate  of  soda  solution,  as  it  greatly  increases  the 


PRACTICAL    ELECTRO-THERAPEUTICS.  21 

conducting  power  of  all  electrodes.  Other  salts  used  for 
this  purpose  are  apt  to  irritate  the  skin.  The  sponge 
electrode  should  be  cleaned  after  each  use.  If  a  large  area 
is  to  be  treated  soap  the  sponge  well  with  a  good  shaving 
soap  to  permit  its  being  moved  about  easily.  The  electrode 
should  be  moved  about  slowly  to  avoid  sudden  starts  of 
muscle  action. 

Varying  degrees  of  pressure  applied  to  an  electrode  will 
cause  a  variation  in  dosage.  Build  up  the  dosage  as 
tolerance  increases.  Over  reddened  skin  a  current  of  small 
amperage  will  frequently  bite,  while  on  a  pale  skin  it  rray 
not  be  felt  at  all.  For  electrolytic  purposes  the  active 
electrode  should  be  well  insulated,  except  where  action  is 
wanted.  A  coating  of  shellac,  or  melted  hard  rubber,  may 
be  molded  about  the  electrode. 


Self-Retaining   Electrodes. 

A  large  electrode  is  usually  used  as  the  dispersing  electrode 
and  is  most  conveniently  placed  on  the  sternum,  the  back 
of  the  neck  or  even  the  palm  of  the  hand.  The  resistance 
at  the  surface  contact  must  be  reduced  as  much  as  possible. 
The  density  of  current  must  not  be  so  strong  as  to  cause 
electrolytic  action  on  the  tissues  in  contact. 

The  current  is  always  greater  in  the  polar  than  in  the 
peripolar  zone.  The  density  of  current  varies  directly  as 
its  strength  and  inversely  as  the  area  of  its  cross  section. 
Thus,  beneath  an  electrode  of  two  square  inches  the 
current  density  would  be  twice  as  great  as  beneath  one 
having  four  square  inches,  the  current  strength  remaining 
the  same. 

The  polarity  of  the  direct  current  may  be  determined  by 
means  of  moistened  litmus  paper,  touched  by  the  two  cord 
tips  a  small  distance  apart.  A  blue  discoloration  takes  place 
at  the  negative  pole  and  a  red  at  the  positive  pole.  If  the 


22  PRACTICAL    ELECTRO-THERAPEUTICS. 

current  is  strong  enough  to  decompose  water,  bubbles  of 
hydrogen  gas  will  gather  at  the  negative  pole,  and,  being  in 
excess  of  the  oxygen  gathered  at  the  positive  pole,  will  thus 
reveal  the  polarity.  The  positive  pole  is  spoken  of  as  the 
anode,  while  the  negative  is  referred  to  as  the  cathode. 

If  a  leash  of  needles  is  used  and  some  of  the  needles  are 
not  doing  their  share  of  work  let  them  remain  in  place  for  a 
time  after  the  others  are  withdrawn,  when  their  current  will 
be  concentrated  along  their  paths  and  the  desired  action 
obtained.  If  it  is  found  in  electrolysis  that .  the  electrode 
can  not  be  readily  disengaged,  owing  to  the  coagulation  and 
drawing  of  the  tissue  about  it,  turn  off  the  current  and 
reverse  the  polarity  and  turn  the  current  on  again  for  a  few 
seconds.  The  moistening  effect  of  the  negative  pole  will 
release  the  electrode  so  that  it  can  be  removed  without 
difficulty. 

At  the  conclusion  of  the  treatment  the  negative  needle  is 
easily  withdrawn,  and  it  is  found  to  be  bright  and  untarnished. 


.Needle  Strand. 

The  positive  needle,  on  the  other  hand,  is  withdrawn  with 
difficulty,  as  it  is  adherent  and  it  is  more  or  less  darkened 
and  corroded  according  to  the  amount  of  current  and  time 
consumed  in  the  treatment. 

Current  Diffusion. — The  current  does  not  travel  through 
the  body  straight  like  a  beam  of  light,  but  seems  to  curve 
somewhat  about  the  poles.  Especially  is  this  the  case  in  a 
large  conductor  like  the  human  body,  the  circle  rapidly 
increasing  in  size  as  we  proceed  from  the  pole.  Hence  it  is 
difficult  or  almost  impossible  to  bring  a  concentrated  current 
to  bear  on  organs  or  growths  that  are  beneath  the  surface. 
The  nearest  approach  to  concentration  at  a  distance 
requires  a  heavy  current  at  fhe  pole  contact.  The  effects 
are  determined  by  three  elemenis,  strength,  duration  and 
concentration.  The  cauterant  effects  depend  on  the  polar 
concentration.  An  electrode  of  a  certain  size  with  a  deter- 
mined number  of  milliamperes  may  not  cauterize  in  three 
minutes,  but  may  in  five.  A  half  a  milliampere  applied  at 


PRACTICAL    ELECTRO-THERAPEUTICS. 


23 


the   point  of  a  fine   needle,   as   in  the  epilation  of  hair,  will 
cauterize  in  a  few  seconds. 

It  is  in  the  immediate  vicinity  of  the  poles  that  the  best 
therapeutic  results  are  obtained,  and  the  readiness  with 
which  electrodes  may  be  brought  in  contact  with  diseased 
conditions  is  what  the  therapeutic  effect  depends  upon. 

PHYSIOLOGY  OF  DIRECT  CURRENTS. 

The  direct  current  possesses  chemical  and  physical- 
chemical  properties  of  therapeutic  value  in  the  treatment 


Current  Diffusion. 

of  a  great  variety  of  morbid  conditions.  The  action  of 
the  two  poles  is  directly  opposite  and  it  is  absolutely 
necessary  to  know  which  is  which. 

The  positive  pole  attracts  oxygen,  acts  as  an  acid  caustic, 
is  sedative  in  action,  is  a  vasomotor  constrictor,  hardens 
the  tissues  and  makes  hard,  unyielding  cicatrices. 

The  negative  pole  attracts  hydrogen,  acts  as  an  alkaline 
caustic,  is  irritating  and  stimulating,  is  a  vasomotor  dilator, 
and  liquifies  and  disintegrates  tissues.  Its  cicatrices  are  soft 
and  pliable. 


24 


PRACTICAL    ELECTRO-THERAPEUTICS. 


The  human  body  may  be  regarded  as  made  up  of  tissue 
bathed  in  acids  or  alkaline  solutions.  By  means  of  the  direct 
current  these  fluids  may  be  moved  from  one  part  of  the  body 
to  another.  If,  for  instance,  the  current  be  passed  through 
a  piece  of  muscle  or  beef  the  negative  end  will  become 
swollen  from  accumulation  of  fluids  and  solids,  and  the 
positive  end  will  become  dry  and  mummified,  due  to  the 


Current    Diffusion 

accumulation  of  acids  and  the  absence  of  liquids.  Knowing 
the  action  of  each  pole,  we  place  the  electrode  according  to 
the  action  desired.  For  instance,  we  place  the  positive 
electrode  over  a  painful  and  inflamed  area  to  relieve  the 
congestion  by  its  vasomotor  constrictor  effect.  The  oxygen 
set  free  at  this  pole  assists  in  oxidizing  the  tissue  waste  and 
toxines  which  clog  the  lymphatics,  while  the  sedative  action 


•'WTO? 

-:3^ 


Current  Diffusion  in  Pelvic  Applications. 

of  this  pole  relieves  the  pain.  Absorption  is  stimulated, 
causing  exudations,  effusions  and  morbid  fluids  to  be  re- 
moved from  the  tissues. 

On  the  other  hand  the  negative  electrode  may  be  applied 
for  its  vasomotor  dilator  effects,  thus  causing  a  greater 
abundance  of  nutritive  fluids  to  be  brought  to  the  tissues 
needing  them,  thereby  quickening  metabolism. 


PRACTICAL    ELECTRO-THERAPEUTICS. 


Negative  Electrolysis  for  Bed  Sore. 

The  current  causes  contraction  of  muscular  tissue,  both 
striped  and  unstriped,  and  invigorates  the  processes  that 
depend  upon  muscular  activity.  Thus  it  restores  the 
equilibrium  of  the  circulation  in  the  intestines  and  assists 
the  excretory  organs,  promoting  elimination  and  overcom- 
ing passive  congestion,  and  assists  in  relieving  chronic  cases 
of  constipation. 

By  it  we  obtain  definite  knowledge  concerning  the  action, 
nutrition  and  capacity  of  muscles  and  nerves,  as  by  no  other 
agent,  and  if  the  indications  are  chiefly  those  of  degeneration, 
the  negative  electrode,  by  dilating  the  blood-vessels  with  a 
current  of  ten  to  twenty  milliamperes,  improves  their 
defective  nutrition  as  no  other  agent  at  our  command. 

There  is  no  feeling  beyond  that  of  heat  under  the  negative 
electrode  and  a  numb  feeling  under  the  positive.  As  the 
sensibilities  of  persons  vary,  it  is  necessary  to  have  an  ampere 
meter  to  determine  how  much  work  is  being  done.  It  is 


26  PRACTICAL    ELECTRO-THERAPEUTICS. 

simply  an  impossibility  to  do  good  work  without  a  milliampere 
meter,  as  it  means  nothing  to  say  you  are  using  five,  ten  or 
twenty  cells.  When  using  a  meter  we  can  turn  on  the 
current  until  the  meter  marks  the  required  dosage,  irrespec- 
tive of  patient's  sensibilities. 

The  interruptions  in  the  galvanic  current  disperse  the 
products  of  electrolytic  decomposition  and  permit  more 
vigorous  interchange  between  the  blood  and  the  muscles, 
followed  by  increased  nutrition. 

Experiments  have  demonstrated  that  rhythmic  galvanic 
currents  produce  improvement  in  nutrition  where  the  con- 
tinuous galvanic  current  has  little  or  no  effect.  Experiments 
further  show  that  a  slowly  interrupted  galvanic  current  of 
about  two  milliamperes,  each  contraction  being  followed  by 
a  period  of  repose,  produces  the  best  effect.  A  rapid  rate 
of  change  in  the  constant  galvanic  current  is  unpleasant, 
while  a  slow  rate  is  a  great  comfort. 

Thus  all  the  effects  of  a  powerful,  intermittent  faradic 
current  are  obtained.  The  dose  must  be  modified  to  suit  the 
ascertained  reaction  of  each  patient.  There  is  an  entirely 
different  sensation  imparted  to  the  tissues,  and  there  is  no 
cramping  of  muscles  as  in  the  faradic,  sinusoidal  or 
Leyden  jar  current.  It  makes  contractions  and  then  lets  go. 
Thus  we  often  get  response  in  paralysis  from  the  inter- 
rupted galvanic  when  there  is  no  response  from  the  faradic. 
Don't  exercise  a  muscle  too  fast  or  too  long.  You  may  be 
able  to  run  at  a  certain  speed  for  a  certain  distance,  but  you 
can't  keep  it  up  indefinitely.  The  continuous  current  of 
moderate  strength  applied  gradually  does  not  contract  a 
muscle.  If,  however,  there  is  a  rapid  change  from  maximum 
to  zero  and  vice  versa,  it  determines  muscular  contraction. 

A  given  quantity  of  electricity  passed  in  the  form  of  a 
series  of  swift  shocks,  by  a  unidirectional  current,  may 
throw  an  animal  into  violent  tetanus,  exhaust  the  muscles 
and  nerves,  and  lead  to  gradual  or  sudden  death,  while  the 
same  quantity  passed  as  a  continuous  current  may  leave 
scarcely  any  visible  physiological  effect. 

By  electrolysis  we  mean  the  decomposition  of  a  compound 
body  by  means  of  electricity,  as,  for  instance,  the  decomposi- 
tion of  water  into  oxygen  and  hydrogen.  (It  must  not  be 
confounded  with  galvano-cautery,  which  destroys  tissues 
regardless  of  chemical  composition.)  In  electrolysis  there  is 


PRACTICAL    ELECTRO-THERAPEUTICS.  27 

no  more  heat  than  can  be  accounted  for  by  the  activity  of 
the  chemical  processes. 

The  body  to  be  decomposed  must  be  a  conductor  of  elec- 
tricity and  possess  certain  elements  to  be  an  electrolyte.  So 
far  as  the  human  body  is  concerned  it  may  be  regarded  as  a 
six-tenths  of  one  per  cent,  solution  of  common  salt  (normal 
physiological  saline  solution). 

When  a  current  passes  through  a  tissue  it  is  conducted 
almost  entirely  by  the  inorganic  constituents  contained  there- 
in. Investigation  has  demonstrated  that  no  current  can  pass 
through  the  human  body  without  effecting  electrolytic 
decomposition,  or,  in  other  words,  the  only  medium  of  conduc- 
tion is  chemical  decomposition  or  electrolysis.  It  does  not 
matter  whether  it  is  a  continuous  or  alternating  current. 
Electrolytic  effects  are  produced  not  only  in  the  medium 
immediately  surrounding  the  poles  or  electrodes,  but  also 
in  the  intervening  tract.  (With  the  various  forms  of 
alternating  currents,  little,  if  any,  accumulation  of  elec- 
trolytic materials  takes  place  at  the  poles.)  There  has 
been  decomposition,  recomposition  and  redistribution. 
Conduction  has  been  made  possible  by  the  conveyance  of  the 
charge  from  atom  to  atom  in  the  intra-polar  circuit.  There 
is  a  movement  of  salts  and  fluids  from  the  anode  (positive 
pole),  toward  the  cathode  (negative  pole),  the  free  ions 
appearing  at  the  poles.  This  action  is  easily  observed  in 
the  decomposition  of  water,  which  in  its  pure  state  is 
practically  a  non-conductor.  Animal  fat  is  a  bad  conductor. 
In  living  tissue  the  current  is  conducted  by  means  of  the 
blood-vessels,  the  connective  tissue  and  fluids.  In  dead 
tissue  the  resistance  is  enormously  increased  and  practically 
acts  as  an  insulator. 

Under  the  microscope  the  tissues  about  the  positive  pole 
appear  as  though  acted  upon  by  acetic  acid,  the  muscles 
and  fibers  are  sharply  defined  and  uninjured,  no  matter 
how  great  the  change  of  the  contents  might  be.  When  elec- 
trolysis alone  is  desired  the  electrodes  must  be  composed  of 
some  material  not  acted  on  by  the  galvanic  current,  as 
platinum,  gold  or  carbon. 

The  action  of  the  current  is  best  studied  on  a  piece  of  beef. 
The  glazed,  dried  appearance  of  the  tissues  about  the  positive 
pole  is  partly  due  to  the  cataphoric  action  of  the  current  in 
driving  liquids  away  from  the  vicinity  of  the  positive  pole, 


28  PRACTICAL    ELECTRO-THERAPEUTICS. 

and  partly  to  the  action  of  the  acids,  muriatic,  nitric, 
sulphuric  and  phosphoric,  collected  at  the  positive  pole. 

Around  the  negative  pole  the  appearance  is  just  the 
opposite.  The  moist  and  swollen  tissue  is  surrounded  by  a 
frothy  alkaline  liquid.  The  alkalies  here  collected  are  soda, 
potash,  lime  and  ammonium. 

The  positive  pole  affects  the  tissues  as  an  acid  caustic. 
It  coagulates  albumen  and  shrinks  tissues,  causing  a 
superficial,  dry,  hard  cicatrix.  It  stimulates  absorption 
by  contracting  the  blood-vessels,  and  thus  producing  de- 
creased nutrition.  The  contact  of  the  positive  pole  with 
the  mucous  lining  by  a  metal  electrode  is  very  painful  and 
not  easily  borne.  Oxidation  of  metal  electrodes  takes  place 
at  this  pole,  and  deposits  of  metallic  salt  are  made  in  the 
tissues. 

The  negative  pole  affects  the  tissue  as  an  alkaline  caustic, 
causing  a  deep  red,  moist,  soft  condition.  Scars  left  are  soft 
and  retractile.  Therefore,  when  we  have  a  dense,  fibrous 
tissue  to  resolve  or  remove  we  use  the  negative  pole.  It 
is  also  used  to  avoid  the  white  scar,  usually  following  the 
application  of  the  positive  pole. 

If  the  current  is  applied  mildly  it  acts  as  a  chemical 
absorbent  and  changes  the  histological  structure  of  dense 
fibrous  tissue,  whether  the  result  of  inflammation  or  other 
pathological  process.  The  details  of  the  process  by  which 
this  is  brought  about  are  still  a  matter  of  speculation. 
Probably  the  hydrogen  gas  forming  in  the  tissues  tends  to 
expand  the  interstices  of  the  connective  tissues,  which  are 
abnormally  dense  and  impenetrable,  and  that  access  of 
nutritive  fluids  is  more  freely  established  as  well  as  conditions 
more  favorable  for  absorption. 

The  desiccating  action  of  the  positive  pole  renders  it  of 
value  in  lessening  congestion  and  checking  hemorrhage,  while 
the  congesting  effect  of  the  negative  pole  renders  assistance 
in  impaired  nutrition  in  dilating  orifices  or  canals  and  in 
promoting  flow  of  drainage. 

Galvanic  burns  heal  slowly.  There  is  hot,  burning  pain 
at  the  needle.  Dry  resistance  and  friction  mean  heat.  The 
parts  should  be  saturated  with  an  alkaline  hot  water,  which 
will  dilate  the  capillaries,  and  friction  will  be  less  and  com- 
fort more. 

In  certain  joint  diseases,  ulcers,  bed  sores,  etc.,  manifest- 


PRACTICAL    ELECTRO-THERAPEUTICS.  29 

ing  feeble  reparative  activity,  the  cause  may  have  been 
primarily  an  injury,  a  bacterial  infection  or  an  inflammation 
of  other  origin,  leaving  obstruction  from  organized  or 
unorganized  exudates.  The  electric  energy  may  be 
transformed  into  physiological  energy  and  the  reparative 
process  is  strengthened. 

If  inflammatory  exudates  or  excess  of  connective  tissue 
growth  is  the  retarding  cause  aside  from  the  devitalized  state 
of  the  living  cells,  the  action  of  the  negative  pole  quickens 
the  protoplasmic  combination  necessary  for  nutrition,  aids 
in  bringing  more  nutritive  material  and  assists  in  the  disin- 
tegration of  the  overgrowth  of  connective  tissue  elements 
(cathodal  electrolysis).  Thus  bed  sores,  chronic  ulcers, 
with  horny-like  margins,  are  soon  changed  into  healthy 
surfaces,  and  granulating  surfaces  are  aroused  to  quick 
repair  by  daily  application  of  the  negative  current  about 
their  margins  with  a  strength  of  about  one  milliampere  per 
square  centimeter  of  electrode  surface.  As  bacteria  are 
usually  in  some  defenseless  or  weakened  area,  thus  tuber- 
cular joints  may  improve  when  treated  daily  for  fifteen  to 
twenty  minutes. 

The  strength  of  current  must  fall  short  of  an  amount  that 
would  result  in  electrolysis  of  the  mucous  membrane  or 
cuticle  (less  than  fifteen  to  twenty  milliamperes).  Eight  to 
fifteen  minutes.  Keep  electrode  gently  moving  over  limited 
area  during  the  application  so  that  too  great  a  density  is 
not  employed  at  one  point. 

Cathodal  electrolysis  is  also  used  in  the  removal  of  non- 
vascular,  dense,  horny  or  warty  moles  and  superfluous 
hair.  A  retrograde  action,  the  reverse  of  tissue  building, 
can  usually  be  started  in  these  abnormal  or  redundant 
deposits. 

Anodal  Electrolysis. — Local  derangement  of  blood-vessels, 
such  as  naevi,  cirsoid  aneurism,  aneurism  hemorrhoids, 
abnormal  vascular  growths  of  any  kind,  can  have  their  blood 
supply  cut  off  neatly  and  easily  without  resulting  scar  tissue. 
An  abnormal  growth  may  be  arrested  by  robbing  it  of  its 
blood  supply  by  the  destruction  of  blood  and  lymph  vessels. 
Such  growths,  when  treated,  gradually  shrink  and  are 
absorbed,  leaving  the  normal  tissues  in  possession  of  the  field, 
with  an  opportunity  to  repair  damage  with  a  minimum 
amount  of  cicatrical  tissue.  Moles  and  naevi  must  be 


30  PRACTICAL    ELECTRO-THERAPEUTICS. 

treated  with  noncorrodible  metals,  such  as  gold  or  platinum, 
as  the  ordinary  metal  needle  leaves  a  disfiguring  metallic 
deposit  in  the  skin.  A  great  advantage  lies  in  the  fact  that 
the  electrolytic  effect  can  be  limited  to  destroy  only  the 
vitality  of  abnormal  cells. 

In  the  removal  of  fibroids  needle  or  trocar-shaped  electrodes 
are  used,  insulated,  except  at  the  part  thrust  into  the  growth, 
in  order  to  protect  the  skin.  Twenty  to  thirty  milliamperes 
are  used  for  from  three  to  five  minutes. 

A  double  needle  electrode  may  be  used,  confining  the  cur- 
rent to  the  tissues  between  them.  The  needles  may  be  coated 
with  an  insulating  coat  of  white  varnish  or  vulcanite  and 
thoroughly  dried,  the  tip  of  the  needle  being  protected  from 
varnish  by  thrusting  it  into  a  cork. 

The  destruction  of  fibroid  tissue  at  the  end  of  the  electrode 
results  in  a  rapid  absorption  of  the  tumor.  Care  must  be 
taken  not  to  pierce  normal  tissue  or  to  destroy  more  of  the 
tumor  at  one  sitting  than  can  be  absorbed.  Fifty  milliam- 


Hemorrhoidal  Needle  Electrode. 

peres  may  be  used  without  too  great  densit;/  at  any  one  point 
if  a  leash  of  needles  is  used  for  five  minutes.  This  current 
is  employed  extensively  in  the  treatment  of  goiters  of  fibroid 
nature,  hypertrophy  of  the  prostate,  fibroid  growths  of 
mammae,  lymphatic  glands,  and  fibromata  of  the  uterus.  It 
frequently  causes  a  rapid  diminution  in  the  size  of  tumor  or 
tissue.  Infection  is  possible  and  must  be  guarded  against. 
Treatments  may  be  given  at  intervals  of  from  three  to  four 
days. 

Electric  belts  or  body  batteries  are  capable  under 
the  direction  of  an  intelligent  physician  of  accomplishing  a 
great  deal  of  good  in  stimulating  nutrition.  Though  the 
current  is  very  small  and  of  but  a  few  milliamperes  and  few 
volts'  pressure,  it  is  capable  of  doing  great  harm  unless 
employed  with  a  correct  knowledge  of  the  physics  of  elec- 
tricity and  a  clear  conception  of  the  disease  to  be  combated. 
Polarity  must  be  taken  into  account,  also  the  current 
strength  and  the  time  it  would  be  safe  to  allow  them  to  be 


PRACTICAL    ELECTRO-THERAPEUTICS.  31 

used.  Their  use  is  very  limited,  but  have  been  known  to  do 
a  great  deal  of  good  in  joint  diseases  and  chronic  ulcers. 

By  cataphoresis  is  meant  the  introduction  of  a  medicament 
into  the  body  by  means  of  a  galvanic  current,  the  medicament 
traveling  through  the  tissues  beneath  the  skin  with  the 
current. 

The  pole  selected  for  drug  application  will  vary  with  its 
electrical  affinity  to  the  metal  contained  in  the  salt  acted 
upon.  Acids  travel  from  negative  to  positive  poles  and  vice 
versa.  The  large  majority  of  drugs  travel  from  the  positive 
to  the  negative  pole.  Iodine  bromin,  chlorin  and  oxygen 
are  exceptions  to  this  rule.  Potassium  iodide,  being  very 
soluble,  carries  iodine  into  the  tissues  in  a  less  caustic  form 
than  iodine  alone,  and  goes  in  faster  and  in  greater 
quantity. 

Drugs  containing  alcohol,  ether  or  chloroform  permeate 
the  skin  and  mucous  membrane  readily  by  aid  of  the  galvanic 


Electrode  for  Drug  Cataphoresis. 

current.  Cocaine,  aconite,  atropine  and  other  drugs  are 
thus  employed. 

Cocaine  on  the  positive  pole  has  a  decided  local  anesthetic 
effect,  and  will  frequently  relieve  neuralgia  when  the  current 
alone  is  without  avail. 

A  fifteen  to  twenty  per  cent,  solution  of  cocaine  in  water 
may  be  used  with  a  current  of  from  five  to  ten  milliamperes 
for  ten  minutes.  The  negative  pole  may  be  held  in  the  hand 
of  patient.  The  skin  must  be  thoroughly  freed  from  its  fats 
by  means  of  soap,  water  and  alcohol.  It  does  not,  however, 
produce  anesthesia  enough  for  the  performance  of  minor 
surgical  operations.  In  minor  operations,  cocaine  diffused 
throughout  the  tissues  by  using  the  hypodermic  needle  as  the 
positive  electrode  has  been  found  very  effective. 

Galvano-cocaine  anesthesia  produced  with  eight  per  cent, 
solution  of  cocaine  in  guaiacol  is  profound  and  facilitates 
minor  surgical  operations.  One  to  three  milliamperes  will 


32  PRACTICAL    ELECTRO-THERAPEUTICS. 

produce  anesthesia  in  four  to  five  minutes,  which  may  last 
thirty  minutes.  It  may  also  be  used  in  dentistry  to  deaden 
sensitive  dentine.  Guaiacol  seems  to  localize  the  action  of 
cocaine,  preventing  its  dispersion  through  the  body. 

Salts  diffused  into  the  tissues  do  not  produce  tissue  elec- 
trolysis, but  remain  in  the  tissues  as  a  partly  insoluble 
albumino-metallic  salt,  exercising  by  selective  affinity,  a 
denutritive  absorbent  action  on  diseased  structures.  The 
electrodes  employed  in  electric  diffusion  of  metallic  salts  are 
in  the  form  of  needles  or  bulbs. 

The  bulbs  are  used  in  treating  diseased  tissue,  and  the 
needles  when  it  is  necessary  to  penetrate  diseased  growths. 

As  the  positive  electrode  is  the  one  always  employed  in 
metallic  diffusion,  the  electrode  must  always  be  kept  moving 
to  prevent  adhesion  and  consequent  damage  to  the  mucous 
surface.  If  adhesion  should  accidentally  occur  reverse  the 
polarity;  this  will  release  the  electrode.  Bulbs  and  needles 
should  always  be  polished  before  using.  Solutions  of  various 
metallic  salts  may  be  employed  on  the  deeper  tissues  of  nasal 
cavities,  bladder  and  vagina,  by  means  of  special  electrodes. 

Electric  diffusion  of  metallic  salts  from  soluble  electrodes 
may  be  instructively  studied  in  experiments  on  hard-boiled 
eggs  or  butchers'  beef. 

Mercury  may  be  administered  by  amalgamating  gold 
electrodes  with  this  metal,  i.  e.,  causing  the  mer- 
cury to  adhere  to  the  electrode  surface  by  first  dip- 
ping the  latter  into  weak  acids  and  then  into  mercury. 
Employed  as  a  positive  pole  the  mercury  disappears  together 
with  probably  a  minute  quantity  of  gold  and  is  diffused  in 
the  immediate  vicinity  of  the  electrode  along  the  line  of 
current  flow,  enabling  us  to  saturate  neoplasms  and  even 
cancerous  tissue. 

Intranterine  applications  of  metallic  electrolysis  may  be 
made  with  any  oxidizable  electrodes,  such  as  copper  or  zinc, 
which  are  the  most  popular  at  present,  but  electrodes 
made  of  silver,  iron,  lead  or  tin  may  also  be  used. 

When  a  soluble  metallic  electrode  is  used  there  is  no  caus- 
tic action,  as  is  the  case  when  non-attackable  electrodes  are 
employed,  the  current  energy  being  expended  on  the  elec- 
trode and  in  diffusing  the  newly  formed  salts  into  the  tissues. 
When  slight  action  only  is  required  the  electrode  should  be 
kept  in  motion  and  a  low  current  strength  employed  (fifteen 


PRACTICAL    ELECTRO-THERAPEUTICS. 


33 


Diagnostic  Outfit. 

to  twenty  milliamperes).  A  caustic  action  is  produced  if  the 
current  is  beyond  thirty  milliamperes,  but  this  degree  is 
rarely  exceeded.  The  duration  of  the  application  varies 
from  five  to  fifteen  minutes.  If  the  electrode  becomes 
adherent  it  can  usually  be  successfully  detached  by  rotating 
it  on  its  axis  before  attempting  to  withdraw  it.  If  necessary 
reduce  current  strength  to  zero  and  use  negative  polarity 
for  four  to  five  minutes,  which  will  detach  the  adherent 
electrode. 

Malignant  tumors  may  at  times  be  destroyed  when  placed 
under  the  cataphoric  diffusion  of  the  electrolytic  salts  of 
mercury  or  zinc.  The  radiating  chemicals  unite  with  the 
protoplasm  of  the  cells  and  other  elements  of  the  growth, 
producing  a  rapidly  enlarging  area  of  necrosis,  which  is 
found  to  be  more  readily  effective  in  the  degenerating  tissues. 
A  current  of  from  five  hundred  to  eight  hundred  milliameters 


34 


PRACTICAL    ELECTRO-THERAPEUTICS. 


applied  from  thirty  to  sixty  minutes  is  usually  necessary. 
At  the  termination  of  the  application  the  growth  has  been 
changed  into  a  lead-colored  soft  area,  with  a  distinct  edge, 
constituting  the  area  of  necrosis,  surrounding  which  will  be 
found  a  reddened,  slightly  swollen  ring,  constituting  the 
zone  of  sterilization.  Necrose  portions  remain  sterile  and 
odorless  until  separation  takes  place,  which  usually  occurs 
from  seven  to  twenty-one  days  later,  the  wound  healing  by 
granulation. 


Galvanic  Stimulation. 

Cancer  germs  are  killed  in  situ,  preventing  the  auto-infec- 
tion of  the  cut  edges  that  usually  follows  extirpation  by  means 
of  the  knife.  The  operation  is  bloodless. 

Cataphoresis  also  permits  the  destruction  of  small  growth 
or  infected  glands,  etc.  It  permits  localized  destruction  of 
growths  within  inaccessible  cavities,  such  as  the  mouth,  the 
rectum,  etc.  Being  perfectly  under  control,  it  is  capable 
of  being  directed  at  any  point  at  will.  When  the  disease  is 
not  too  extensive  it  may  possibly  be  eradicated.  Failing 
in  this  it  may  be  a  great  palliative. 


PRACTICAL    ELECTRO-THERAPEUTICS. 


35 


In  addition  to  electrolysis  and  cataphoresis,  which  are 
effects  obtained  only  for  the  galvanic  current  of  considerable 
amperage,  we  have  the  distinct  functional  stimulation  and 
sedation. 

By  virtue  of  the  fact  that  stimulation  and  sedation  occur 
only  on  the  instant  of  variation  of  slight  currents  of  high 
voltage  it  is  confined  principally  to  the  galvanic  and  faradic 
currents.  The  functional  stimulation  produced  is  propor- 
tionate to  the  amount  of  variation  and  to  the  suddenness 


Galvanization  of  Pneumcgastric  Nerve. 

or  the  increased  speed  of  variation.  For  speed  of  variation 
we  might  substitute  pressure,  for  the  greater  the  pressure 
the  less  milliamperage  we  require  to  produce  stimulation. 
Nerve  stimulation  is  thus  limited  to  the  opening  and  closing 
of  the  circuit  when  a  weak  current  is  used.  With  a  strong 
current  the  stimulation  or  sedation  continues  throughout  the 
application,  producing  a  contraction  or  sensation.  All  cur- 
rent variations  are  stimulant,  though  the  continuous  galvanic 
current  is  sedative  at  the  positive  pole,  and  very  rapidly 
successive  faradic  currents  of  high  voltage  and  minute 


3G  PRACTICAL    ELECTRO-THERAPEUTICS. 

amperage  will  act  as  an  analgesic.  The  action  is  always 
greatest  when  the  concentrating  electrode  is  over  the  nerve. 

Tissues  exposed  to  the  negative  pole  of  the  galvanic  cur- 
rent are  distinctly  increased  in  their  excitability  to  stimu- 
lize.  A  positive  pole  has  a  contrary  effect.  The  irrita- 
bility of  the  parts  is  markedly  decreased.  The  stimula- 
ting and  sedative  effects  of  the  galvanic  current  are  equally 
active  on  nerve  and  muscular  tissue,  and  it  is  probable  that 
the  glands  and  secretory  organs  respond  to  this  current 
independently  of  their  enervating  and  trophic  nerves.  The 
general  tissue  stimulating  action  of  this  current  is  demon- 
strated by  the  activity  produced  in  tissue  metabolism,  nutri- 
tive repair  and  emphatic  activity  of  the  pelvic  organs. 

When  applying  general  galvanic  stimulation  the  patient 
must  be  disrobed  and  lying  on  a  couch.  A  large  dispersing 
electrode  should  be  placed  over  the  back  and  connected  with 
the  positive  pole.  To  the  negative  cord  is  attached  a  round, 
active  pad,  well  moistened  and  soaped.  The  pad  is  held  in 
contact  with  the  patient  and  the  current  is  turned  on,  after 
which  the  pad  is  passed  over  the  nerve  points  of  each  group 
of  muscles,  taking  care  to  act  only  on  the  groups  associated 
in  action  at  one  time.  The  current  strength  depends  on  the 
part  of  the  body  and  the  amount  of  adipose  tissue  covering 
the  points.  Fleshy  persons  require  more  current.  Fifteen 
to  twenty  milliamperes  will  do  for  the  arms,  ^thirty  to  thirty- 
five  on  the  legs  and  thigh  and  fifty  and  over  for  the  abdomen 
and  back.  In  weak  and  nervous  people  treatments  are  apt 
to  be  followed  by  a  short  period  of  vascular  depression  and 
cold  extremities.  But  as  strength  is  gained  the  warm  reac- 
tion is  more  immediately  realized. 

The  galvanic  current  will  be  found  preferable  to  faradic 
stimulation  in  the  cases  usually  placed  on  the  rest  cure,  the 
strong  current  transmitted  through  the  abdominal  viscera 
being  particularly  valuable  in  arousing  dormant  abdominal 
nervous  forces  so  commonly  deranged  in  these  cases. 

Delicate  patients  who  have  been  treated  for  grave  condi- 
tions of  debility  had  better  sit  or  lie  down  and  rest  for  a 
while  after  the  treatment.  A  nervous  chill  sometimes 
follows  over-electrization.  The  system  can  become  habitu- 
ated to  electricity  the  same  as  it  becomes  accustomed  to 
opium  or  any  other  potent  remedy.  Extremely  sensitive 
patients  nearly  always  bear  a  longer  and  much  stronger 


PRACTICAL    ELECTRO-THERAPEUTICS.  37 

application  after  a  course  of  treatments.  Patients  need  not 
necessarily  be  discouraged  if  short  treatments  with  gentle 
currents  only  can  be  borne  at  the  beginning. 

When  a  headache  persists  for  some  time  after  a  treatment, 
a  mistake  has  been  made  somewhere  in  the  application. 
Sudden  shocks  and  interruptions  may  cause  momentary 
headaches,  which  pass  away  after  a  short  time. 


THE  FARADIC  CURRENT. 

The  faradic  current  is  produced  in  a  closed  wire  circuit 
placed  over  or  close  to  another  in  which  a  galvanic  current 
is  varied.  The  strength  of  the  current  so  produced  is  pro- 
portionate to  the  strength  of  the  producing  current  plus  the 
length  of  the  wire  subjected  to  the  influence  of  the  inducing 
current  circuit.  Convenience  necessitates  the  coiling  of  one 
insulated  wire  about  the  other,  producing  a  solenoid  or 
induction  coil  in  which  many  feet  of  wire  occupy  but  a  small 


space.  It  is  necessary  that  the  two  wires  carrying  the 
inducing  and  the  Induced  current  should  be  close  to  each 
other  and  properly  insulated. 

The  action  of  the  inducing  current  from  the  cell  in  the 
first  coil  is  increased  if  a  soft  iron  core  be  inserted  within  it, 
making  what  is  called  an  electro-magnet.  The  value  of  an 
electro-magnet  depends  upon  the  fact  of  its  being  able  to 
rapidly  acquire  and  as  readily  to  lose  its  magnetism. 

Electro-magnetism  is  supposed  to  be  electricity  in  rota- 
tion, and  is  supposed  to  know  no  barrier  and  to  travel  from 
the  north  pole  to  the  south  pole.  Certain  metals  under 
certain  conditions  exert  an  attractive  or  repulsive  influence 

38 


PRACTICAL    ELECTRO-THERAPEUTICS. 


39 


on  each  other.  Science  has  not  been  able  to  tell  us  what 
these  forces  are,  but  it  has  formulated  laws  under  which 
these  forces  act  and  react. 

The  theory  is,- that  the  ions  in  the  space  surrounding  the 
conductor  through  which  the  direct  current  is  flowing  are 
influenced  by  the  current,  causing  them  to  move  about  it  in 
a  certain  direction.  These  ions  are  very  close  together 
near  the  conductor,  and  farther  apart  as  their  distance  from 


the  conductor  increases.  A  general  idea  may  be  had  from 
this  illustration. 

Increasing  the  strength  of  the  current  increases  the 
diameter  of  existing  circles  of  whirling  ions. 

The  cell  current  traverses  the  primary  coil  and  returns  to 
the  cell  through  the  interrupter.  While  traversing  this  coil 
the  current  makes  the  core  magnetic,  which  in  turn  at- 
tracts the  small  armature  on  the  interrupter,  breaking  the 


v^^AvV"vv;v";'VvA:^^v 

N^*^--^..» — .»..,- — <..--..-».^_x..<^.-^  .-»...» — * 

Magnetic  Whirls. 

cell  current.  The  magnetism  of  the  core  having  now  dis- 
appeared, the  spring  returns  to  contact,  when  the  whole 
process  is  repeated. 

.Induced  currents  are  only  caused  by  the  changing  strength 
of  the  magnetic  field  surrounding  the  secondary  circuit. 
If  a  constant  current  is  passing  in  the  primary  circuit  there 
will  be  no  induced  currents,  the  strength  of  current  depend- 
ing on  the  abruptness  of  change  in  the  primary  circuit,  and 


40  PRACTICAL    ELECTRO-THERAPEUTICS. 

their  direction  will  depend  upon  whether  the  primary  current 
increases  or  decreases. 

The  Vibrator. — There  should  be  at  least  two  adjustable 
vibrators,  one  for  slow  vibrations  of  fifty  to  one  hundred 
and  fifty  periods  per  minute,  giving  muscles  time  to  rest 
between  each  alternate  contraction,  but  permitting  adjust- 
ment of  from  two  hundred  to  two  thousand  periods  per 
minute  for  producing  muscular  massage;  and  one  for  seda- 
tion, with  a  rapid  vibration  adjustable  for  seven  to  nine 
thousand  periods  per  minute. 


Faradic  Apparatus,  Showing  Primary  and  Secondary  Coil. 

The  vibrator  must  be  kept  well  polished  and  thoroughly  free 
from  oxidation,  for  starts  and  jerks  in  the  vibratory  move- 
ment are  often  unpleasant  and  sometimes  harmful. 

In  the  primary  coil  the  patient  is  placed  in  what  is  called 
a  shunt  circuit,  permitting  only  an  infinitesimal  amount  of 
current  to  traverse  the  tissues  when  the  spring  is  in  con- 
tact, the  resistance  of  the  coil  being  many  ohms  less  than 
that  of  the  body  of  the  patient.  It  will  be  seen  that  all  the 
circuit  takes  the  short  road  through  the  cell  instead  of 
through  the  patient.  The  current  gets  much  of  its  force 
from  the  demagnetization  of  the  coil.  At  the  moment  of 
closure  of  the  cell  current,  a  reverse  does  arise  in  the  primary 
coil  by  self-induction,  but  never  readies  the  patient.  When 
the  cell  current  is  open  at  the  interrupter,  however,  the 
primary  direct  induction  arising  in  the  primary  coil  has  no 


PRACTICAL    ELECTRO-THERAPEUTICS. 


41 


General  Faradization. 

recourse  but  to  traverse  the  patient.  This  induced  current 
gets  much  of  its  force  from  the  demagnetization  of  the  core, 
and  since  it  is  produced  in  a  coil  nearer  the  core  than  the 
secondary  wire,  the  volume  of  the  current  is  greater,  other 
factors  remaining  the  same.  The  direct  inductions  only  can 
reach  the  patient,  the  inverse  inductions  being  neutralized 
by  the  cell  current. 

In  a  simple  coil  of  but  few  turns  a  current  arises,  flow- 
ing in  one  direction  in  the  second  wire  on  closing  the  cell 
circuit  in  the  first,  and  another  current  arises  on  opening 
the  cell  circuit.  The  current  that  appears  in  the  secondary 
coil  on  opening  the  cell  circuit  is  in  the  same  direction  as 
the  cell  current,  while  the  current  that  appears  in  the 
secondary  at  the  closing  of  the  cell  circuit  is  inversed,  the 
current  in  the  secondary  coil  being  thus  a  to-and-fro 
current. 

No  amount  of  electrolysis  can  be  caused  on  account  of  this 
continuously  neutralizing  character  of  an  alternating  cur- 


42  PRACTICAL    ELECTRO-THERAPEUTICS. 

rent.  It  is  this  same  condition  that  makes  it  impossible  for 
us  to  measure  the  current  strength.  No  current  arises  in 
the  secondary  coil  unless  its  ends  are  closed  by  a  patient  or 
other  conductor. 

The  large  amperage  of  one  or  more  galvanic  cells  is 
transformed  into  a  current  with  a  large  electromotive  force 
and  with  a  current  strength  of  but  a  few  milliamperes. 
What  is  lost  in  amperage  is  gained  in  voltage. 

The  voltage  or  penetrating  power  of  the  secondary  coil 
depends  upon  the  length  and  diameter  of  the  wire  used  and 
on  the  number  of  windings.  A  coil  with  twenty  windings 
possesses  twenty  times  the  electromotive  force  of  one  wind- 
ing. A  coarse  wire  with  an  equal  number  of  turns  as  a  fine 
wire  lias  the  same  voltage.  The  fineness  of  wire  merely 
reduces  the  volume  of  current.  A  coil  of  an  equal  number 
of  windings  of  fine  wire  will  have  less  amperage,  and  a  heavy 
wire  coil,  other  things  being  equal,  will  have  a  larger 
amperage.  A  coil  wound  with  heavy  wire  acts  on  the  muscles 
and  not  on  the  sensory  nerves,  hence  is  less  painful.  The 
fine  wire  acts  on  the  sensory  nerves  and  not  on  the  muscles. 
When  the  secondary  coil  is  only  partly  over  the  primary  coil 
the  resistance  of  the  secondary  coil  remains  the  same, 
while  its  voltage  is  reduced. 

Any  unevenness  in  its  action  may  be  readily  detected  by 
connecting  the  various  cells  with  a  telephone  receiver.  The 
quality  of  the  interruptions  with  slow  and  rapid  vibrations 
may  be  studied. 

The  quantity  of  current  is  due  to: 

1.  The  galvanic  current  inducing  the  flow. 

2.  The  primary  coil. 

3.  The  number  of  windings  on  the  secondary  coil. 

4.  Thickness  of  wire. 

5.  Character  of  interruptions. 

6.  Position  of  coil  over  the  primary. 

7.  Surface  resistance. 

8.'   Kind  and  size  of  electrodes  used. 

One  or  two  galvanic  cells  are  sufficient  to  operate  a  faradic 
coil,  and  although  it  would  be  impossible  by  means  of  sensa- 
tion to  detect.a  current  from  these  cells,  yet  there  is  a  marked 
sensation  when  the  terminals  of  the  primary  coil  are  taken 
hold  of.  It  is  not  the  current  from  the  batteries  which  we 


PRACTICAL    ELECTRO-THERAPEUTICS.  43 

feel,   but  the  current  induced,   in   the  windings  of  the  coil, 
by  the  influx  and  withdrawal  of  the  magnetic  lines. 

An  apparatus  now  on  the  market  consists  of  a  set  of 
three  coils.  Two  switches  on  the  end  permit  of  tapping  and 
using  different  lengths  of  wire  from  the  same  coil. 

PHYSIOLOGY  OF  COIL  CURRENTS. 

The  uses  of  the  induction-coil  currents  are  limited  in  their 
range  of  influence  as  compared  with  those  of  the  direct  cur- 
rent, their  range  being  the  physiological  responsiveness  of  the 
tissues.  Nevertheless,  a  large  amount  of  valuable  work 
can  be  done  with  a  coil  the  frequency  of  whose  interruptions 


Faradic  Battery. 

can  be  varied  at  the  will  of  the  operator,  and  in  which  the 
electromotive  force  in  both- the  primary  and  secondary  circuit 
may  be  conveniently  modified. 

The  effects  of  coil  currents  are  tonic  and  stimulating  or 
sedative  and  paralyzing,  depending  on  the  technique  em- 
ployed. 

Slowly  interrupted  coil  currents  have  little  action  on 
non-striated  muscles,  but  when  rapidly  interrupted  these 
muscles  respond  vigorously,  each  fiber  contracting  suc- 
cessively. The  normal  movements  of  the  arteries  and 
arterioles  are  stimulated,  thus  accelerating  the  flow  of  blood 
and  lymph  through  the  tissues  and  relieving  venous  stasis, 
absorption  is  promoted  and  elimination  of  waste  material 


44 


PRACTICAL    ELECTRO-THERAPEUTICS. 


increased.     The  action  of  this  current  is  more  mechanical 
than  medicinal. 

A  coarse  wire  coil  is  to  be  preferred  where  there  is  a  loss 
of  tone  and  venous  engorgement,  and  it  is  contraindicated 
where  the  tissues  are  sensitive  and  inflamed.  On  account 
of  the  low  voltage  a  large  electrode  should  be  used  and  the 
skin  should  be  saturated  thoroughly.  Slowly  interrupted 
currents  of  from  thirty  to  fifty  periods  per  minute  produce  a 
series  of  muscular  contractions,  with  an  intervening  period 


General  Faradization. 

and  relaxation  and  rest.  This  physiological  activity  has  a 
marked  .effect  on  the  improvement  of  nutrition.  Rapid 
interruptions  produce  tetanic  contractions,  which  in  turn 
bring  about  a  muscular  anemia,  and  if  prolonged  will  pro- 
duce degeneration.  Thus  we  see  why  a  tetanizing  current 
decreases  neuromuscular  nutrition.  The  coarse-coil  current 
lacks  penetrating  power  on  account  of  its  low  voltage,  and, 
being  limited  to  a  smaller  area,  it  has  greater  stimulating 
qualities. 

Relief  brought  about  by  the  positive  pole  of  the  galvanic 


PRACTICAL    ELECTRO-THERAPEUTICS. 


45 


current  is  less  harmful  and  more  permanent  than  that 
obtained  by  tetanic  contractions. 

The  action  of  the  alternating  current  on  non- striated 
muscle  fibers  decreases  rapidly  in  diseased  conditions,  such 
as  paresis,  atony,  etc.  It  is  a  current  of  higher  voltage, 
penetrates  more  deeply  and  is  more  diffused.  Its  action 
is  spent  on  a  larger  tissue  area. 

The  primary  effect  of  the  stimulating  treatment  may  be  a 
feeling  of  depression  and  lassitude,  and  soreness  and  fatigue 


Applying  General  Faradization  by  Means  of  Hand 


may  follow  the  first  treatment.  This  can  only  be  avoided  by 
making  the  first  treatment  tentative  and  by  using  the  hand 
as  an  electrode.  In  timid  women  and  in  the  treatment  of 
children  it  is  best  for  the  physician  to  use  the  moistened  hand 
as  an  electrode  until  all  fear  is  allayed,  the  hand  being  more 
agreeable  to  the  patient,  more  flexible  and  adaptable,  and 
has  a  lightness  arid  softness  of  touch,  particularly  for 
applications  to  the  head  and  sides  of  the  neck.  It  also  keeps 
the  operator  informed  of  the  current  strength.  He  can 


46  PRACTICAL    ELECTRO-THERAPEUTICS. 

increase  or  diminish  the  current  by  tightening  or  loosening 
his  grasp  upon  the  wet  sponge. 

The  polarity  of  the  faradic  current  is  as  distinct  as  that  of 
the  galvanic.  The  secondary  also  has  a  distinct  polarity, 
though  not  so  marked  as  the  primary,  the  direct  inductions 
being  stronger  and  more  abruptly  produced  than  the  inverse 
productions,  the  electrode  on  the  negative  pole  being  the 
most  stimulating  and  the  positive  the  most  sedative. 

It  increases  tissue  metabolism,  increases  the  absorption  of 


Applying  Faradic  Current  by  Means  of  Hand. 

oxygen  and  elimination  of  a  corresponding  amount  of  carbon 
dioxide.  It  therefore  accelerates  functional  activity.  This 
can  be  readily  demonstrated  by  grasping  a  bi-polar  electrode 
in  the  hand,  and  using  a  fine  wire  current  as  strong  as  can 
be  borne  for  a  few  minutes.  The  hand  becomes  bathed  in 
perspiration;  it  also  becomes  pale  and  bloodless,  due  to  the 
tetanic  contraction.  Its  power  to  promote  rapid  absorption 
of  inflammatory  exudates  may  be  attributed  directly  to  its 
stimulation  of  the  capillary  and  lymphatic  circulation. 


PRACTICAL    ELECTRO-THERAPEUTICS.  47 

The  increased  contraction  and  the  subsequent  relaxation 
empty  and  fill  the  capillary  vessels  and,  together,  with 
increased  blood  pressure,  favor  the  removal  of  any  obstruc- 
tion in  them.  By  stimulating  the  contraction  of  adjacent 
muscles  the  veins  are  emptied,  inviting  the  blood  from  the 
overloaded  capillaries.  The  lymphatic  circulation  is 
stimulated  by  the  same  process. 

Muscular  exhaustion  is  almost  instantaneously  relieved, 
and  the  lightness  and  buoyancy  experienced  in  the  muscles 


Anodal  Electrolysis  in  Intercostal  Neuralgia. 

exercised  are  due  to  the  increased  supply  of  blood  and  oxygen 
to  the  muscle.  Rapidly  interrupted  induced  currents  produce 
a  vibratory  movement  in  the  protoplasm  of  the  body.  We 
can  appreciate  the  influence  of  this  current  when  we  realize 
that  nine  tenths  of  the  body  is  composed  of  protoplasm. 

Faradization  usually  gives  a  refreshed  and  exhilarated 
feeling,  usually  following  immediately  upon  treatment,  and 
may  last  for  hours.  In  others  a  fatigued  and  exhausted  feel- 
ing may  follow,  with  an  intense  desire  for  sleep.  Patients 


48  PRACTICAL    ELECTRO-THERAPEUTICS. 

suffering  from  nervous  pains  in  the  head,  back,  side,  stomach 
and  limbs  frequently  find  relief  during  or  shortly  after  treat- 
ment. 

The  disagreeable  symptoms  which  sometimes  follow  general 
faradization,  headache,  malaise,  vertigo,  chilliness,  faintness 
and  cold  perspiration,  are  not  permanent,  but  are  like  similar 
effects  from  the  injudicious  use  following  other  tonics. 
Extreme  nervousness  may  cause  unnecessary  alarm. 

The  graphite  rheostat  used  with  the  direct  current  is  also 
used  with  the  induction-coil  current,  as  the  most  sensitive 
patient  will  permit  stronger  current  when  applied  gradually. 
By  varying  the  pressure  of  the  electrode  held  in  the  hand 
the  current  may  also  be  increased  or  decreased.  Great  care 
must  be  exercised  in  applying  the  current  over  bony  surfaces, 
as  they  are  always  painful.  The  treatment  with  the  faradic 
current  is  less  likely  to  aggravate  the  disease  than  the 
galvanic,  as  there  are  no  chemical  effects.  It  is  mechanical 


Current-Interrupting  Electrode  Handle. 

and  physiological  in  its  nature,  having  no  cataphoric  or 
electrolytic  action  like  the  poles  of  the  galvanic  current. 

A  moist  conductor  conveys  the  faradic  current  through 
the  skin  to  the  nerves  and  muscles  beneath,  while  the  dry 
metallic  is  used  in  moist  cavities  only.  The  difference 
between  the  electromotive  force  between  the  galvanic  and 
faradic  current  may  be  demonstrated  by  touching  the  bare 
terminals  of  each. 

In  paralysis  the  paretic  neurons  and  impaired  muscles  may 
be  improved  in  nutrition.  Stimulation  of  the  vaso-motor 
nerves  of  the  bowels  increases  peristalsis  and  accelerates  the 
blood  to  the  intestines,  promotes  secretion  and  relieves  con- 
stipation. Glandular  secretions  are  also  stimulated. 

When  the  intensity  of  the  current  has  been  arranged,  the 
frequency  of  the  interruptions  must  be  considered.  If  the 
treatment  is  given  with  a  view  of  stimulating  the  nutrition 
of  weakened  and  impoverished  muscles,  they  must  not  be 


PRACTICAL    ELECTRO-THERAPEUTICS.  49 

made  to  contract  with  such  frequency  as  to  further  exhaust 
them.  Slow  interruptions  with  complete  and  uniform  con- 
tractions meet  the  need  in  such  conditions.  A  rheotome,  or 
a  break-circuit  handle,  can  be  used  to  bring  about  these 
interruptions. 

Short  treatments  are  the  rule.  When  there  are  a  hundred 
or  more  interruptions  per  second  there  is  a  benumbing  or 
anesthetic  effect  produced  on  the  nerve  supplying  the  part. 
A  rapidly  and  smoothly  interrupted  faradic  current 
benumbs  the  nerves  and  abolishes  pain.  The  rapidity  of 
interruptions  varies  the  quality  of  the  physiological  effect. 
From  five  to  three  hundred  interruptions  determine  the 
muscular  actions,  while  the  sedative  effects  are  produced 
by  very  rapid  interruptions  of  twenty  thousand  to  fifty 
thousand  per  minute.  Muscle  contractions  cease  with  this 
rapidity.  Slow  interruptions  favor  muscle  contractions; 
rapid  interruptions  affect  the  nerve.  The  anesthetic  effect 
increases  with  the  number  of  windings,  thinness  of  the  wire 


Faradic  Brush  Electrode. 

and  rapidity  of  the  interruptions.  A  fine  coil  with  thirty-five 
volts  and  thirty-five  hundred  interruptions  a  minute  is 
frequently  not  felt  after  five  minutes  until  moved  up  to  fifty 
volts. 

In  bi-polar  applications  the  effects  from  a  short,  heavy  coil 
are  stronger  and  of  greater  physiological  effect  than  from  a 
fine  wire.  As  the  resistance  of  the  tissue  increases  fine  coil 
indications  improve.  A  current  in  a  short  wire  gives  a 
shorter  spark  with  greater  heat.  A  fine  wire  gives  a  long 
spark  with  less  heat. 

A  powerful  secondary  induction  coil  made  of  two  hundred 
and  eighty  miles  of  wire,  with  three  hundred  and  forty 
thousand  turns,  yields  a  spark  forty-two  and  one-half  inches 
long  when  operated  by  thirty  Grove  cells. 

Low  surface  resistance  renders  the  current  less  painful 
and  more  penetrating  without  affecting  the  superficial  sen- 
sory nerves,  yet  acting  with  energy  upon  the  deep-seated 
muscles.  Where  we  desire  to  stimulate  the  nerve  terminals 


50 


PRACTICAL    ELECTRO-THERAPEUTICS. 


General  Faradization. 

in  the  skin  a  dry  electrode  serves  this  purpose  best,  since 
the  resistance  due  to  lack  of  moisture  intensifies  the  cur- 
rent at  this  point.  The  wire  brush  electrode  is  well  adapted 
when  counter-irritant  effects  are  desired. 

It  is  well  known  that  any  impression,  mechanical,  chemical, 
terminal  or  electrical,  made  on  the  terminal  sensory  nerves 
is  carried  to  the  central  ganglion,  where  it  is  capable  of 
modifying  function  or  of  even  producing  organic  change. 
The  difference  between  the  sensation  caused  by  the  cathode, 
or  negative,  and  the  anode,  or  positive  pole,  depends  on  the 
size  of  the  electrode.  If  the  anode  is  small  and  cathode 
large,  the  current  will  be  stronger  under  the  anode,  due  to 
difference  in  current  density.  The  current  density  varies 
directly  with  the  current  strength  and  inversely  as  the 
surface  area  of  the  electrode. 

It  is  absolutely  necessary  for  the  physician  to  have  the 


PRACTICAL    ELECTRO-THERAPEUTICS.  51 

therapeutic  properties  of  the  various  currents  firmly  fixed 
in  his  mind.  He  must  know  how  to  regulate  the  electromo- 
tive force  and  how  to  determine  the  number  of  interruptions 
necessary  in  a  given  case.  The  susceptibility  of  the  patient 
and  the  varying  tolerance  of  the  different  portions  of  the 
body  will  also  require  special  study. 

On  account  of  the  anatomical  formation  of  the  chest 
strong  currents  are  not  tolerated,  yet  currents  of  sufficient 
strength  to  increase  physiological  development  are  borne 
with  comfort.  There  is  no  action  produced  on  the  heart- 
and  lungs,  the  application  being  merely  a  muscular  stimulant. 
In  some  patients  the  splenic  and  hepatic  regions  are  unac- 
countably tender  and  justify  the  suspicion  that  these  organs 
may  be  more  or  less  diseased.  The  current  applied  directly 
to  the  abdomen  acts  directly  on  all  organs  contained, 
regardless  of  nerve  supply.  Adipose  tissue  is  a  poor  con- 
ductor and  must  be  considered  when  treating  corpulent  per- 
sons. 

On  account  of  the  physiological  importance  of  the  cilio- 
spinal  centers,  they  should  be  given  special  attention  in 
every  general  faradic  treatment.  The  current  is  also  used 
in  treating  spasmodic  and  hysteric  contraction.  Treatment 
must  continue  until  the  muscle  is  thoroughly  relaxed,  but 
repeated  application  may  be  necessary. 

Nervous  and  active  people  respond  to  this  current  more 
readily  than  do  the  cold  and  phlegmatic.  The  nutrition  of 
the  entire  nervous  system  is  directly  influenced  by  this 
current.  In  an  ordinary  application  the  brain,  the  spinal 
cord  and  the  sympathetic  ganglion  are  all  subjected  to  the 
action  of  the  current.  The  tonic  effect  of  faradization  is 
largely  due  to  the  passive  exercise  which  it  produces.  It  is 
both  deep  and  superficial.  The  molecules  are  agitated  just 
as  the  particles  of  a  bar  of  iron  are  moved  by  the  influence 
of  magnetization.  Every  atom  is  kept  in  incessant  dis- 
turbance. 

A  current  too  weak  to  cause  muscular  contraction  is  not 
followed  by  a  marked  tonic  effect.  The  idea  is  to  bring 
about  not  only  a  contraction,  but  a  relaxation.  The  relaxa- 
tion will  in  itself  bring  about  an  increased  flow  of  blood  to 
the  parts. 

Assimilation  depends  upon  equalization  of  the  circulation. 
The  tissues  of  the  body  are  frequently  developed  in  size  and 


52  PRACTICAL    ELECTRO-THERAPEUTICS. 

firmness  to  a  marked  degree,  and  vigor  is  frequently  imparted 
to  those  deficient  in  power  by  means  of  this  current. 


GALVANO-FARADIZATION. 


Vigorous  faradization  alone  produces  fatigue.  The  use 
of  the  refreshing  and  invigorating  galvanic  current  in  con- 
junction with  the  faradic  enables  us  to  obtain  the  therapeutic 
qualities  of  the  first  without  the  exhausting  effects  on  the 
patient. 


Combined  Galvanic  and  Faradic  Currents. 

The  effect  is  obtained  by  uniting  the  secondary  induction 
coil  and  the  galvanic  battery  in  one  circuit  by  connecting 
with  a  wire  the  negative  pole  of  one  and  the  positive  pole  of 
the  other,  attaching  the  electrodes  to  the  two  extreme  poles 
and  sending  the  currents  through  the  body. 

This  current  is  especially  indicated  in  diseases  of  .the 
abdominal  viscera  and  of  the  bowels. 

Interrupted  induction-coil  currents  increase  metabolism 
by  action  in  the  muscular  system.  Increased  nutrition  is 
produced  in  two  ways,  muscular  contraction  and  stimulation 
of  terminal  sensory  nerves,  action  on  cell  function  and  pro- 
moting gland  activity. 

Galvano-faradization  is  like  adding  two  drugs  to  be 
administered  in  one  prescription.  Spasmodic  conditions 
which  have  failed  to  respond  to  either  of  the  other  currents 
applied  alone  are  relaxed  almost  immediately  by  galvano- 
faradic  electricity. 
.0  I  H  "l  / 


ELECTRIC  BATH 

The  tub  should  be  of  wood  or  porcelain,  otherwise  the 
current  will  travel  through  the  metal  instead  of  through 
patient  and  the  water.  It  must  not  be  in  metallic  connection 
with  the  earth,  and  the  waste  pipe  and  water  faucets  should 
not  be  connected  directly  with  the  bath,  but  a  rubber  tubing 
used. 

An  ordinary  bath  tub  may  be  used  if  a  piece  of  rubber 
sheeting  large  enough  to  cover  the  inside  of  a  bath  tub  be 
used. 

With  a  current  of  moderate  amperage  and  low  electro- 
motive force,  insulation  is  not  necessary.  If,  however,  we 
wish  to  make  use  of  all  the  therapeutic  properties  of  the 
electric  bath,  insulation  becomes  necessary,  and  is  accom- 
plished by  placing  the  tub  on  insulating  supports  of  glass  or 
vulcanite. 

There  are  two  kinds  of  electric  baths,  namely:  monopolar 
and  dipolar. 

Monopolar. — One  electrode  is  placed  to  the  nape  of  neck, 
arm  or  some  other  part  of  the  bod}'  out  of  the  water.  The 
water  bath  constitutes  the  other  electrode  and  very  carefully 
adapts  itself  to  all  parts  of  the  submerged  body,  the  copper 
electrode  in  the  water  completing  the  circuit.  If  the  positive 
current  is  used  outside  of  the  water,  the  current  from  this 
electrode  will  flow  into  the  body,  diffusing  itself  into  the 
water  from  all  parts  of  the  patient,  to  be  again  concentrated 
at  the  negative  electrode. 

Only  a  moderate  current  can  be  employed  outside  of 
water,  as  a  too  concentrated  one  would  cause  pain  and  pro- 
duce destiuction  by  local  electrolytic  action. 

The  dipolar  bath  is  the  one  most  used.  The  electrodes 
are  usually  made  of  copper,  the  larger  electrode,  twelve  by 
eighteen  inches,  being  used  at  the  head,  while  the  smaller 
electrode,  nine  by  twelve  inches  in  size,  is  placed  at  the  foot 
end.  The  shoulders  must  not  come  in  contact  with  the 
electrodes,  as  this  would  cause  a  burning  pain.  The  soles 
of  the  feet,  on  account  of  poor  conductivity,  may  be  placed 
against  the  foot  electrode. 

53 


54 


PRACTICAL    ELECTRO-THERAPEUTICS. 


The  current  may  be  continuous  or  alternating.  The 
steady  current  may  be  obtained  from  the  medical  galvanic 
battery,  but  must  be  under  control,  hence  the  necessity  for 
a  good  rheostat  and  milliamperemeter. 

The  patient  should  not  be  left  alone  in  the  bath,  and  pulse 
and  respiration  should  be  carefully  counted  during  the 
administration. 

It  has  been  estimated  that  about  twenty  per  cent,  of  the 
entire  current  passes  through  the  patient.  Thus,  if  the 
milliampere  registers  one  hundred  and  fifty,  the  patient  is 
subjected  to  a  current  of  about  twenty-five  milliamperes. 


Electric  Bath. 

The  current  should  be  turned  on  gradually,  observing  the 
effect  on  the  patient.  The  temperature  used  is  usually 
about  98J/20  F.,  but  it  must  be  remembered  that  the  higher 
the  temperature  the  better  its  conducting  capacity.  When 
the  physician  can  command  any  current  strength  desired, 
the  temperature  of  the  water  makes  little  difference.  The 
addition  of  salts  to  the  water  increases  the  conducting 
capacity  of  the  water  and  lessons  the  current  strength 
passing  through  the  patient. 

Various  drugs  dissolved  in  the  water  may  be  carried  into 
the  body  by  means  of  cataphoresis.  Extracts  of  herbs  and 
barks  have  been  used  with  effect  in  a  variety  of  troubles. 
According  to  an  eminent  European  authority,  tannic  acid, 
which  is  much  cheaper  than  the  lithium  salts,  is  very  effective 
in  the  treatment  of  uric  acid  troubles. 

Never  give  a  bath  to  a  patient  immediately  after  he  has 
had  a  full  meal. 


PRACTICAL    ELECTRO-THERAPEUTICS.  55 

The  effects  of  an  electric  bath  are  exhilarating,  refreshing 
and  invigorating  to  the  patient.  Circulation  and  nutrition 
are  benefited  and  irritability  relieved,  and  sleep  is  restored, 
and  new  vigor  imparted  to  mental  and  physical  faculties.  The 
cutaneous  glands  are  stimulated  to  increased  elimination  of 
effete  material,  and  by  increasing  the  amount  of  blood 
brought  to  the  surface  it  relieves  the  congested  internal 
organs. 

-  For  tonic  effects  the  interrupted  currents  give  the  best 
results. 

Gout,  rheumatism,  lumbago  and  sciatica  have  been  suc- 
cessfully treated  by  the  various  currents.  If  the  alternating 
current  causes  pain  the  direct  current  should  be  used. 

In  disordered  circulation,  as  found  in  Raynaud's  disease,  the 
electric  bath  is  the  best-known  treatment.  Weak  currents 
are  used  to  build  up  the  nutrition  of  the  parts  diseased.  The 
negative  pole  is  applied  over  the  diseased  area,  the  object 
being  to  increase  circulation  in  the  diseased  member. 

Chronic  rheumatism,  rheumatoid  arthritis,  gout  and  dia- 
betes are  diseases  in  which  a  judicious  selection  of  currents 
and  proper  attention  to  detail  in  a  course  of  electric  baths 
will  accomplish  more  than  massage,  medicament,  change  of 
climate,  or  all  of  them  combined. 

Neurasthenia  frequently  yields  to  electric  baths  when 
central  galvanism  and  static  electricity  have  failed. 

Diphtheria  and  other  forms  of  toxic  neuritis  are  effectively 
treated,  as  it  increases  the  activity  of  the  organs  of  elimina- 
tion. 

In  giving  an  electric  douche,  the  indifferent  electrode  is 
placed  under  the  patient's  feet,  or  under  the  gluteal  region 
if  the  patient  is  seated.  The  water  from  the  nozzle  consti- 
tutes the  other  electrode.  The  water  from  the  nozzle  renders 
the  skin  a  good  conductor  of  electricity  and  at  the  same  time 
increases  the  cutaneous  irritability,  rendering  the  action  on 
the  periphery  stronger  and  more  effective.  Its  conductivity 
is  increased  by  raising  the  temperature  of  the  water  and  also 
by  the  addition  of  salt  or  sodium  bicarbonate.  The  nozzle 
must  be  held  at  some  distance  from  the  body  and  the  flow  of 
water  must  be  delivered  in  an  unbroken  stream. 

As  the  stream  of  water  constitutes  the  active  electrode, 
this  form  of  treatment  is  adapted  to  a  large  number  of 
pathological  conditions,  applied  to  mucous  cavities  and  the 


56 


PRACTICAL    ELECTRO-THERAPEUTICS. 


mucous  canal.  In  treating  cavities  electrified  water  may 
be  used.  -The  whole  surface  of  the  cavities  may  thus  become 
more  completely  electrified  than  otherwise.  The  fluid  must 
come  in  contact  with  the  metal  electrode  within  the  nozzle. 

Five  to  twenty  milliamperes  may  be  used,  the  application 
lasting  ten  minutes.  It  may  also  be  used  in  cases  where  the 
urethra  is  sensitive  to  the  passage  of  a  bougie  or  metal 


Urethral   Electrode  for  Giving  Electric  Douche. 

electrode.  Electricity  thus  applied  allays  irritability,  heals 
sore  or  bleeding  points  and  prepares  cases  for  electrolytic 
treatment.  It  reduces  the  inflammation  which  is  frequently 
present  and  which  prevents  the  introduction  of  instruments 
on  account  of  the  pain  produced.  It  cures  some  maladies 
of  the  prostate  and  allays  irritation,  and  cases  of  impotence 
have  been  reported  cured  in  this  manner. 


Hydro-Electric  Rectal  Tubes  and  Catheters. 

Chronic  urethritis  is  more  safely  treated  by  this  method 
than  by  any  other,  because  it  dilates  and  puts  the  mucous 
lining  on  the  stretch,  thus  cleansing  all  the  parts.  The 
current  is  equally  divided  and  better  tolerated.  By  hanging 
the  bag  higher  there  is  no  doubt  but  that  the  posterior 
urethra  is  reached. 

The  dangers  and  difficulties  of  applying  strong  galvanic 
currents  to  mucous  canals  and  cavities  are  obviated  by  the 


PRACTICAL    ELECTRO-THERAPEUTICS.  57 

use  of  special  electrodes,  completely  insulated  and  perforated 
to  allow  the  passage  through  them  of  a  current  of  water  and 
electricity,  the  water  in  the  canal  constituting  the  true  elec- 
trode. 

A  one  per  cent,  solution  of  common  salt  water  may  be  used, 
though  medicated  solutions  of  copper,  zinc  or  silver  may 
be  employed,  the  various  salts  being  driven  into  the  tissues 
by  cataphoric  action  of  the  constant  current.  The  inflam- 
matory infection  of  the  uterine  canal,  ulcerations  of  the 
cervix,  relaxed  vaginal  walls  and  weakened  pelvic  structures 
are  thus  conveniently  treated  by  means  of  the  vaginal  electric 
douche.  The  temperature  of  the  water  must  be  regulated 
to  suit  the  patient.  In  treating  the  bladder  from  twenty  to 
thirty  milliamperes  may  be  used.  Under  this  treatment, 
vesical  atrophy  or  weakness  is  much  benefited  and  good 
results  have  been  obtained  in  inflammatory  conditions. 

By  means  of  a  special  electrode  a  current  of  from  twenty 
to  thirty  milliamperes  can  be  employed  within  the  rectum 
without  danger  of  electrolytic  action.  The  wafer  is  allowed 
to  flow  until  the  rectum  becomes  filled;  the  water  in  the 
bowel  constitutes  the  active  electrode,  and  diffuses  the  cur- 
rent to  all  parts  of  the  rectum  and  powerfully  stimulates 
peristalsis.  The  alternating  current  will  cause  non-striated 
muscle  fibers  to  contract  when  not  pathologically  altered. 
Experiments  have  proved  that  non-striated  muscle  fibers 
when  in  paretic  condition  do  not  respond  to  coil  currents, 


Rectal  Hydro  Electrode. 

while  vigorous  contraction  can  be  produced  by  the  galvanic 
current.  Inflammation  and  ulceration  of  rectal  mucosa  are 
frequently  speedily  cured  by  this  means.  Its  use  in  chronic 
constipation  should  be  familiar  to  all  physicians. 

Catarrh  of  the  nose  and  naso-pharynx  are  much  relieved 
and  frequently  entirely  cured  by  the  electric  douche. 

In  atrophic  nasal  catarrh,  the  diseased  glands  may  be 
modified  in  their  function  and  the  function  of  the  mucous 
membrane  improved.  In  catarrh  of  the  nose  it  may  be  found 


58 


PRACTICAL    ELECTRO-THERAPEUTICS. 


serviceable  to  add  various  medicaments  to  the  water  used. 
Among  these  cupric  sulphate  is  perhaps  the  best.  Atrophic 
cases  of  catarrh  have  been  reported  cured,  with  complete 
return  of  the  sensation  of  smell.  From  three  to  tenmilliam- 
peres  are  used,  the  application  lasting  until  three  pints  of 
water  pass  through. 


Massey     Galvanic.  Faradic  and  Cautery  Battery. 


GALVANO-CAUTERY. 

Energy  can  not  be  lost.  In  disappearing  it  reappears  in 
some  other  form.  Whenever  resistance  is  placed  in  the  path 
of  an  electric  current  it  can  overcome  the  resistance  only  by 
giving  up  part  of  its  energy,  which  reappears  in  the  form 
of  heat.  It  is  this  property  which  is  used  in  the  heating  of 
lamps  and  cauteries. 

Either  the  commercial  current,  storage  cells  or  a  battery 
with  large  zinc  and  carbon  elements  may  be  used. 


Giant  Cautery  Battery. 

Metals,  fluids,  etc.,  all  show  a  difference  in  ability  to 
receive  heat  from  some  source  or  other.  Thus,  a  platinum 
wire  held  over  a  Bunsen  burner  will  show  a  temperature  three 
times  higher  than  a  copper  wire  under  same  length-  of 
exposure.  Also,  if  a  silver  and  platinum  wire  were  held 
over  the  Bunsen  burner  together,  the  platinum  would  be  red 
hot  while  the  silver  would  be  still  comparatively  cold.  It  is 
estimated  that  each  molecule  requires  the  same  amount  of 
heat  to  raise  its  temperature  a  certain  number  of  degrees 
Thus  we  see  a  clear  relationship  between  thermal  capacity 
and  specific  gravity.  The  greater  the  mass  in  weight  of  the 
conductor,  the  more  time  will  it  require  to  effect  a  rise  in 
temperature.  There  is  also  some  similarity  between  thermal 
and  electrostatic  capacity. 

69 


60 


PRACTICAL    ELECTRO-THERAPEUTICS. 


Cautery  Electrodes. 


PRACTICAL    ELECTRO-THERAPEUTICS. 


61 


Electric-cautery  has  been  extensively  used  and  its  recog- 
nition is  well  deserved.  It  has  supplanted  almost  entirely 
the  chemical  agents  formerly  used,  being  completely  under 
the  control  of  the  operator.  The  instrument  may  be  carried 
without  harm  through  a  narrow  or  complicated  passage 


New  Dry  Cell  Cautery  Battery. 

until  it  reaches  the  desired  point  of  action,  and  when  the 
effect  is  complete  it  may  be  withdrawn  equally  harmlessly. 
As  a  remedial  measure,  galvano-cautery  is  perhaps  most 
frequently  resorted  to  by  the  nose  and  .throat  specialist  for 
the  reduction  of  hypertrophic  tissue,  the  cauterization  of  the 
seat  of  the  implanted  mucous  polypi,  ignipuncture  of  the 
tonsils,  etc. 


MAGNET. 

The*  use  of  a  magnet  has  become  the  principal  means  of 
extracting  foreign  metallic  bodies  from  the  eyeball.     A  small 


Giant  Eye  Magnet. 

magnet  may  be  used  where  the  foreign  body  is  embedded  in 
the  superficial  portions  of  the  eye.     When  imbedded  in  the 


New  Portable  Haab  Magnet. 

deeper  portions  of  the  eye,  a  giant  magnet,  regulated  by  a 
rheostat,  will  frequently  avoid  an  otherwise  delicate  opera- 

62 


PRACTICAL    ELECTRO-THERAPEUTICS.  63 

tion.  In  fact,  may  prevent  enucleation  in  many  cases.  In 
opacities  of  the  eyeball,  it  is  no  doubt  a  great  aid  in  making 
a  diagnosis  as  to  whether  metal  is  present  in  the  eye  or  not. 


Small  Eye  Magnet. 


The  magnet  has  also  been  successfully  used  in  the  removal 
of  a  pin  from  a  child's  larynx  or  bronchus. 

Electricity  also  plays  an  important  role  in  a  variety  of 
mechanical  appliances,  such  as  electric  drill  motors,  mechan- 
ical nasal  saws  and  vibratory  massage  operators. 


ILLUMINATION. 

The  electric  light  is  used  more  generally  than  any  other 
illuminating  agent  in  the  examination  of  the  nose,  throat, 


Lamp  Holder 


Tongue  Depressor 


Illuminating  Instruments. 


ear  and  bladder.  The  incandescent  lamp  has  its  special 
advantage  in  this  purpose,  of  which  these  illustrations  give 
ample  evidence. 


64 


SINUSOIDAL  CURRENT. 

The  sinusoidal  current  is  an  alternating  current  generated 
by  induction  in  a  coil  of  wire  which  is  rapidly  revolved  in 
the  magnetic  field  of  another  coil  and  core. 

This  current  can  be  secured  from  any  apparatus  having  a 
permanent  magnet  or  any  coil  having  a  temporary  magnet. 
The  rapidity  of  the  revolutions  of  the  armature  determine 
the  character  of  the  sinusoidal  current.  It  is  best  generated 
by  an  apparatus  turned  by  an  electric  motor  in  order  to 
get  the  greatest  speed  and  the  most  regular  curves  or 
waves. 


Apparatus  for  Generating  Sinusoidal  Current. 

In  an  armature  or  coil  which  is  revolving  in  a  circle  and 
making  a  revolution  back  to  the  starting  point,  always  in 
the  same  direction  and  not  stopping  to  swing  back  as  the 
pendulum  vibrator  does,  there  is  consequently  no  dead  point, 
and  the  make  and  break  is  not  felt  painfully  or  with  any 
shock.  This  produces  a  harmonic  or  sinuous  wave-like  con- 
traction and  a  soothing  or  pleasant  sensation,  relieving  pain 
and  often  producing  anesthesia,  by  causing  temporary 
paralysis  or  tetanization  of  the  nerves. 

The  physiological  effects  produced  by  the  sinusoidal  cur- 
rents are  painless  and  have  great  penetrating  power.  The 

5  65 


66 


PRACTICAL    ELECTRO-THERAPEUTICS. 


constant  alternation  of  the  current  prevents  polarization  of 
the  tissues  acted  upon,  and  hence  maintains  the  maximum 
exciting  effect.  Various  effects  are  noticed  according  to 
whether  the  machine  is  rotated  at  a  high  or  low  rate  of 
speed.  When  rotated  slowly  the  contractions  are  vigorous 
and  spasmodic,  rather  than  tetanic  in  character. 

Strong  muscular  contractions  may  be  induced  without  the 
slightest  sensation  to  the  skin  and  without  any  pain  what- 
ever. With  rapid  rotation  of  the  machine  the  current  is 
capable  of  producing  strong  tetanic  contractions  similar  to 
those  of  the  faradic  machine. 


ASINUSDIOAL   510  70  CYCLES  PER  SECOND 

B  OSCILLtTINC  „  „  ,  ,  STROKES 

C    WAVE  1,11      II   WAV  E.I  I  li  mi 

P  INTERRUPTED  n  n  n in,  BREAKS  II 11 1 


The  Cedergren  Sinusoidal  Apparatus. 


STATIC  ELECTRICITY. 

Static  Electricity. — The  ethereal  theory  presupposes  that 
electricity  in  a  neutral  or  mixed  condition  is  present  every- 
where, pervading  all  space,  penetrating  between  molecules, 
etc.  When  two  dissimilar  substances  are  placed  in  contact, 
one  of  them  always  assumes  the  positive  and  the  other  the 
negative  charge.  It  was  formerly  thought  that  only  a 
limited  number  of  bodies  could  produce  an  electric  charge 
when  brought  in  contact  with  each  other,  but  later  investi- 
gation shows  that  friction  between  any  two  bodies  of  differ- 
ent substances  will  produce  an  electric  charge. 

The  amount  of  electric  charge  or  energy  stored  up,  in 
either  of  these  bodies,  is  not  in  proportion  to  the  work  done 
by  friction,  but  only  in  the  small  work  done  in  separating 
the  bodies  against  their  mutual  attraction,  which  depends 
upon  whether  they  are  good  conductors  or  not.  If  a  charge 
is  communicated  to  one  end  of  a  glass  rod,  it  will  remain 
there,  and  not  pass  to  the  other  end,  as  it  is  a  poor  conduc- 
tor. Metal  is  a  good  conductor  and  offers  no  resistance  to 
the  rapid  distribution  of  the  charge. 

From  the  foregoing  statements  it  is  seen  that  negative 
and  positive  electricity  are  not  generated,  but  merely  moved 
from  one  body  to  another.  It  is  impossible  to  bring  forth 
one  charge  without  bringing  forth  the  other.  There  is  a 
difference  of  potential  between  parts  of  the  same  body  or 
between  different  bodies.  The  medium  between  the  two 
forms  of  electricity  is  in  a  state  of  strain,  as  they  are 
eagerly  seeking  to  unite  with  each  other  and  again  produce 
a  neutral  condition. 

Friction  is  not  the  cause  of  electricity,  as  is  heat,  but 
friction  dries  and  warms  the  surface,  which  favors  insula- 
tion, and  thus  prevents  the  escape  of  electricity.  Whether 
the  bodies  be  brought  in  contact  by  either  rubbing  or  sliding 
friction,  seems  to  be  immaterial.  The  main  thing  seems  to 
be  to  bring  the  various  parts  of  the  surface  of  one  body 
successively  in  contact  with  the  surface  of  a  dissimilar  body, 
and  separate  them  in  order  to  produce  a  charge. 

67 


68 


PRACTICAL   ELECTRO-THERAPEUTICS. 


To  understand  the  workings  of  a  static  or  influence 
machine,  as  used  in  therapeutic  work,  it  is  necessary  to  bear 
in  mind  that  when  an  electrified  body  is  placed  in  the  vicinity 
of  other  bodies,  insulated  or  not,  it  sets  up  in  these  other 
bodies  electrical  modifications;  that  is,  variations  in  the 
distribution  of  electricity,  acting  upon  them  by  influence. 
While  acting  on  others,  however,  it  is  also  acted  upon.  Its 
repartition  of  electricity  is  being  altered.  Electrical  bodies 
with  similar  charges  are  mutually  repellant,  while  electrical 
bodies  with  dissimilar  charges  are  mutually  attracted.  The 
process  of  generating  a  static  current  is  best  described  by 
means  of  the  following  illustration. 


Diagram  of  Static  Machine. 

The  initial  charge  of  electricity  is  developed  by  friction; 
by  induction  on  the  plate  the  comb  B  will  become  positive 
and  the  knob  at  the  end  of  the  prime  conductor  will  become 
negative.  The  comb,  however,  readily  gives  up  its  positive 
charge  to  the  plate,  so  that  the  prime  conductor  BN  is  left 
negatively  charged. 

When  the  plate  has  made  half  a  revolution  that  part  that 
has  been  charged  positively,  from  the  comb  B,  arrives  at 
comb  C.  Thus  the  two  combs  will  always  be  at  a  different 
potential,  and  a  steady  flow  of  sparks  will  ensue  between 
the  ends  of  the  prime  conductors  P  and  N.  The  electric 
charge  passes  from  the  plate  to  the  positive  comb  and  from 
the  negative  comb  to  the  plate.  When  the  machine  is  oper- 
ated in  a  dark  room  the  difference  in  the  discharge  from  and 
to  the  different  combs  may  be  noticed,  the  purplish  flame 
occurring  on  the  negative  side. 


PRACTICAL    ELECTRO-THERAPEUTICS.  69 

Induction  can  take  place  through  some  distance,  and 
through  materials  such  as  air,  glass,  etc.  When  the 
electrically  charged  body  is  removed  it  will  again  return  to 
its  neutral  condition,  the  inducing  body  having  lost  none  of 
its  charge.  The  smaller  the  distance  between  the  two 
bodies  the  stronger  the  induced  charge. 

As  some  bodies  permit  induction  with  greater  facility,  the 
substance  residing  between  the  two  charges  is  of  import- 
ance. Dry  air  offers  more  resistance  to  induction  than  any 
other  substance.  Electricity  can  not  flow  through  glass, 
yet  it  is  able  to  act  across  it  by  induction.  This  fact  is 
utilized  when  it  is  desired  to  have  a  high  potential  difference 
between  the  two  charges. 

According  to  the  principles  already  explained,  the  Leyden 
jar  is  found  to  be  a  convenient  condenser  of  electrical 
charges.  One  charge  by  attracting  the  other  will  not  allow 
it  to  become  free,  but  will  keep  it  fixed  and  free  from  ten- 
sion. The  capacity  of  the  two  charges  are  correspondingly 
enlarged,  but  will,  of  course,  possess  the  opposite  potential. 

The  Leyden  jar  is  made  of  glass,  coated  inside  and  out 
with  tin  foil,  which  serves  to  distribute  the  charge  over  the 
surface  of  the  glass.  A  brass  rod,  passed  through  a  lid  of 
dry,  well-varnished  wood,  is  connected  with  the  inner  coat- 
ing by  means  of  a  brass  chain. 

To  charge  the  Leyden  jars,  connect  them  to  the  prime 
conductor  of  the  static  machine  and  connect  the  outer  tin 
foil  with  the  earth.  The  positive  charge  on  the  inner  coat- 
ing induces  a  negative  charge  on  the  outer  coating  nearest  the 
glass,  repelling  the  positive  charge,  which  passes  to  the  earth. 

To  prevent  the  charges  on  the  prime  conductor  from 
uniting,  a  spark-gap  is  placed  between  them.  This  causes 
the  charge  to  flow  into  the  jars  on  the  inner  coating  and 
induce  an  opposite  polarity  on  the  outer  coating.  These 
charges  continue  to  flow  into  the  jars,  where  they  are  held 
by  induced  charges  on  the  outside  of  the  jar.  Both  are 
bound,  but  can  not  unite  and  neutralize  each  other.  When 
the  difference  of  the  potential  between  the  charges  of  the 
two  jars  has  reached  such  a  value  that  it  is  able  to  over- 
come the  resistance  of  the  air  gap,  it  will  bridge  it  by  means 
of  a  spark.  When  this  has  taken  place,  the  inside  charges 
have  neutralized  each  other  and  the  outside  charges  are  free 
to  unite.  The  current  is  of  an  oscillating  character. 


70  PRACTICAL    ELECTRO-THERAPEUTICS. 

The  discharge  between  the  poles  of  the  prime  conductor 
tends  to  neutralize  the  electric  charges  on  the  latter,  but 
the  self-induction  of  the  circuit  causes  an  excess  of  current 
to  rush  to  the  respective  poles,  charging  them  the  opposite 
of  what  they  were,  this  condition  being  again  neutralized  by 
a  spark,  etc.  The  frequency  of  oscillations  will  depend 
principally  on  the  volume  of  current  supplied  to  the  jars,  on 
self-induction,  the  air  gap  and  the  resistance  in  the  circuit 
between  the  jars. 

PHYSIOLOGY   OF    STATIC    ELECTRICITY. 

We  have  in  static  electricity  the  remedy  par  excellence 
for  treating  the  patient  as  a  whole  or  locally,  and  there  is 
probably  no  one  agent  at  the  physician's  command  by  which 
so  much  good  can  be  accomplished  as  by  a  skilfully  handled 
static  machine. 

The  more  intimately  the  physician  becomes  acquainted  with 
the  nature  of  static  electricity  and  the  physical  laws  which 
govern  it,  the  more  readily  will  he  comprehend  its  applica- 
tion. 

Static  electricity  as  generated  by  the  modern  machine  is  a 
current  of  extremely  high  voltage  and  a  very  low  volume. 
This  manifestation  of  electrical  energy  belongs  to  that  class 
called  "high-potential,  high-frequency  currents."  \\licn 
we  consider  that  it  takes  about  fifty  thousand  volts'  pres- 
sure to  force  a  spark  across  one  inch  of  air  space,  the  tre- 
mendous potential  energy  of  a  static  machine  becomes 
apparent,  for  the  static  machines  used  in  therapeutic  work 
are  often  capable  of  giving  a  ten  or  twelve-inch  spark.  It 
is  by  reason  of  this  low  volume  that  the  current  may  be 
passed  through  the  tissues  of  the  body  without  inflicting 
injury  and  with  only  a  moment's  discomfiture.  It  is  prob- 
ably the  most  powerful  stimulus  to  nerve  and  muscle  that 
can  safely  be  applied,  to  say  nothing  of  the  rapidity  at 
which  it  imparts  tonicity,  lightness,  buoyancy  and  firmness 
to  soft,  lax  and  enfeebled  muscular  tissues. 

The  physician  well  acquainted  with  his  static  machine 
soon  finds  that  there  are  few  physical  ailments,  except  those 
of  a  surgical  nature,  which  can  not  be  greatly  relieved  by 
one  or  another  of  the  static  modes  of  treatment  intelligently 
applied. 

In  studying  its  action  or  in  applying  it  in  practice,  we 


PRACTICAL    ELECTRO-THERAPEUTICS.  71 

must  remember  that  the  principles  underlying  the  use  of 
static  electricity  are  the  same  as  those  which  govern  the  use 
of  drugs,  and  that  individual  observation  and  experience 
must  teach  us  what  to  expect.  If  static  electricity  would 
do  in  every  case  what  it  has  done  in  some  cases,  it  would 
indeed  be  a  panacea  or  cure-all;  but  it  is,  nevertheless,  a 
fact  that  its  proportion  of  failures  is  not  greater  than  that 
of  drugs  deemed  most  reliable  in  their  action. 

Electricity  in  any  form  is  now  recognized  as  a  mode  of 
molecular  motion  akin  to  light  and  heat.  Every  applica- 
tion of  electricity  to  the  human  body,  whether  general 
or  local,  is  accompanied  by  transformation  of  electrical  energy 
into  some  other  form  of  energy,  either  physical  or  chemical. 

Investigation  and  chemical  analysis  have  demonstrated 
that  static  electricity  increases  metabolism  by  mechanical  as 
well  as  chemical  processes.  Static  electricity  causes  a  con- 
traction of  protoplasm,  thus  causing  a  mechanical  disturb- 
ance of  the  molecular  arrangement,  which  results  in  a  modi- 
fication and  augmentation  of  metabolism  and  a  modification 
of  the  processes  of  nutrition. 

Static  electricity  regulates  the  various  forces  of  the  body 
by  re-establishing  the  disturbed  equilibrium  in  the  different 
organic  functions;  it  accomplishes  this  by  its  action  on 
nerve  fibers,  cells  and  centers. 

The  statement  is  frequently  made  that  "the  relief  brought 
on  by  static  electricity  is  only  temporary  and  not  a  cure." 
This  is  certainly  due  to  a  want  of  thoroughness  and  appre- 
ciation of  the  physiological  effect  taking  place.  It  is  a  fact 
that  what  can  be  accomplished  momentarily  can  by  repetition 
be  made  permanent. 

The  physical  culturist  tells  us  that  to  exercise  a  limb  will 
give  strength.  On  the  face  of  this  it  seems  ridiculous,  for 
by  every  physical  effort  the  much-needed  energy  is  dis- 
sipated. Nature,  however,  over  night,  not  only  replenishes 
what  was  lost,  but  adds  a  little  more  to  it  each  day;  so  that 
an  exercise  which  seems  difficult  to-day  will  become  easier 
on  each  successive  day,  indeed  become  almost  an  uncon- 
scious effort.  It  is  in  some  such  way  that  static  electricity 
affects  the  nerves.  A  nerve,  being  capable  of  vibrating  at 
its  own  normal  rate  temporarily,  can,  by  repeated  efforts 
on  our  part,  be  made  to  assume  its  own  rate  of  vibration 
permanently. 


72  PRACTICAL  ELECTRO-THERAPEUTICS. 

Static  electricity  does  not  replace  destroyed  tissue,  but  by 
its  action  induces  muscular  contractions,  causing  an 
onward  flow  of  the  blood  stream.  These  contractions 
include  the  muscular  coats  of  the  vascular  system.  This 
increased  circulatory  activity,  by  carrying  onward  the 
various  internal  secretions,  stimulates  the  internal  glandular 
organs  to  an  increased  functional  activity,  assisting  not  only 
the  secretory  organs,  but  converting  by-products  into  end- 


Weakening  Current.    Operator's  Foot  on  Platform. 

products  by  the  increased  oxidation,  and  eliminating  toxic 
matter  through  the  skin,  kidneys  and  lungs,  thus  clearing 
the  path  for  nature  and  allowing  her  to  do  her  work  more 
perfectly.  With  this  increased  excretion  and  elimination  of 
waste,  nervous  irritability  is  lessened  and  is  soon  followed  by 
a  relaxation  of  the  entire  nervous  system.  Casts  and 
albumen  frequently  disappear  from  the  urine. 

"Pain  is  the  cry  of  a  nerve  for  better  blood."     One  of 


PRACTICAL   ELECTRO-THERAPEUTICS. 


73 


the  cardinal  dogmas  of  biology  is  that  the  structure  of 
every  living  being  is  passing  through  a  continuous  transfor- 
mation during  its  whole  term  of  existence.  That  these 
transformations  may  be  of  a  healthy  nature,  it  is  necessary 
that  there  be  a  continuous  flow  of  nutritive  fluid.  A  tem- 
porary disturbance  in  the  blood  stream  brings  about  a 
diseased  condition,  and  it  is  absolutely  necessary  to  remove 
this  condition  of  stasis  before  a  healthy,  normal  condition 


Static  Insulation. 

can  be  restored.  Static  electricity,  by  causing  muscular 
contraction  of  the  vascular  system,  is  best  calculated  to 
relieve,  temporarily  at  least,  the  congestion  and  hyperemia; 
pressure  being  thus  removed,  pain  is  diminished  and  a 
healthy  metabolism"  is  induced,  thus  checking  and  modifying 
the  course  of  the  disease,  and  even  rendering  patients  suffer- 
ing from  incurable  diseases  fairly  comfortable. 

During  the  period  of  convalescence  from  any  disease,  the 


74  PRACTICAL   ELECTRO-THERAPEUTICS. 

body  is  practically  below  par  and  therefore  in  a  condition 
to  become  the  seat  of  morbid  processes.  During  this  period 
of  vulnerability  inherited  predispositions  are  apt  to  manifest 
themselves.  Though  static  electricity  has  no  effect  on  germ 
life,  it  removes  this  lowered  condition  of  vitality  essential 
for  germ  growth;  by  inducing  functional  activities  it  assists 
in  the  absorption,  and  enhances  the  assimilation  of  whatever 
medicament  has  been  administered.  This  is  especially  true 


Negative  Spray  in  Pleurisy  or  Intercostal  Neuralgia. 

in  constitutional  diseases,  such  as  syphilis,  Bright's  disease, 
diabetes,  etc.,  where  it  not  only  aids  absorption  but  hastens 
elimination  as  well. 

The  author  believes  static  electrification  to  be  far  superior 
to  oxygen  inhalations  in  uremic  poisoning.  He  has 
repeatedly  taken  a  patient  delirious  with  uremic  poisoning 
and  placed  him  on  an  insulated  couch  and  has  seen  him 
regain  consciousness  in  from  ten  to  twenty  minutes,  accord- 
ing to  the  severity  of  the  intoxication. 


PRACTICAL   ELECTRO-THERAPEUTICS. 


75 


In  cases  of  diabetes  and  nephritis  the  author  has  had 
results  with  the  use  of  static  electricity  and  drugs,  which 
utterly  failed  to  respond  to  drug  medication  alone. 

A  man  or  woman  subjected  to  a  severe  mental  or  physical 
strain  may  avert  the  final  breakdown  by  a  few  properly 
applied  static  treatments. 

Infants  one  and  two  years  old  suffering  from  gastric 
troubles  and  malnutrition  have  vielded  to  static  treatments 


Posture  in  Treating  Neuralgia  of  the  Shoulder. 

after  well-known  specialists  had  failed  to  bring  aid  by 
means  of  drugs  and  carefully  chosen  diet. 

Schoolgirls  at  the  age  of  puberty  may  be  supported  and 
carried  through  this  trying  period  with  entire  satisfaction; 
the  woman  who  is  passing  through  the  menopause,  accom- 
panied by  all  its  nervous  phenomena  (with  no  definite  patho- 
logical basis),  may  be  soothed  and  comforted,  and  have  her 
perverted  nervous  functions  restored  to  their  normal  course. 

Old    people    in    whom   the   powers    of    life   are   waning 


76  PRACTICAL   ELECTRO-THERAPEUTICS. 

brighten  up  wonderfully,  both  mentally  and  physically, 
after  ^a  few  treatments. 

Coincident  with  this  increased  activity  we  have  increased 
appetite,  restored  digestion,  renewed  strength  and  vigor, 
creating  a  feeling  of  refreshment. 

A  person  who  has  not  witnessed  the  great  amelioration  of 
pain  in  lumbago,  intercostal  neuralgia  or  rheumatism  can 
form  no  adequate  conception  of  its  merits. 

Theoretically,  static  electricity  may  be  employed  in  some 
stage  of  every  disease,  but  finds  its  ideal  sphere  in  such 
conditions  as  the  following: 

Malnutrition:  Anemia;  Neurasthenia — Nervous  Exhaus- 
tion; Hysteria;  Muscular  Pain;  Rheumatism;  Neuralgia; 
Lumbago;  Sciatica;  Coccygodynia;  Headache;  Paralysis; 
Chronic  Synovitis;  Reflex  Pain;  Pre-bacillary  Stage  of 
Tuberculosis. 

ESSENTIALS. 

To  be  successful  in  the  use  of  static  electricity  it  is  abso- 
lutely necessary  to  know  the  machine  and  how  to  keep  it  in 
working  order.  The  usefulness  of  the  machine  itself  will  be 
what  the  operator  makes  it  and  no  more.  Brilliant  results 
can  be  anticipated  only  from  the  combination  of  an  effective 
machine  and  a  skilful  operator. 

As  atmospheric  changes  affect  the  nature  of  static  dis- 
charges, the  machine  should  be  placed  in  a  dry  room,  and 
should  be  evenly  and  solidly  fixed  to  give  steady  and  regular 
motion. 

The  loss  by  leakage  through  accumulation  of  dust  and 
moisture  upon  the  surfaces  of  the  insulated  parts  frequently 
interferes  very  markedly  with  the  efficiency  of  the  machine, 
as  the  electricity  is  conducted  away  as  fast  as  it  is  excited. 
Kerosene  oil  or  gasoline  are  the  best  materials  to  use  in 
cleaning  the  plates  or  the  case  of  the  machine  when  they 
have  become  dirty.  After  the  machine  has  been  cleaned,  it 
can  be  dried  out  perfectly  in  a  few  minutes  by  the  use  of  a 
freezing  mixture. 

Take  a  glass  fruit  jar  that  holds  several  quarts,  and  which 
may  be  tightly  sealed.  Fill  this  jar  with  a  mixture  of 
about  one  half  cracked  ice  and  one  half  salt.  Then  seal, 
wipe  thoroughly  and  set  inside  of  the  machine  on  a  plate,  so 
that  the  condensed  moisture  on  the  outside  of  the  jar  may 


PRACTICAL    ELECTRO-THERAPEUTICS. 


be  caught  by  the  dish.  Then  close  the  case  tightly.  If  it 
is  desired  to  dry  the  case  quickly,  run  the  machine  slowly  to 
set  the  air  in  circulation.  A  deposit  of  ice  or  frost  will 
form  rapidly  on  the  outside  of  the  jar.  Permit  the  jar  to 
remain  in  the  case  until  the  coating  of  ice  becomes  quite 
thick.  Then  take  it  out  of  the  case  and  remove  the  coating 
of  ice.  Replace  in  the  case  and  allow  a  second  coating 
to  accumulate.  Never  allow  the  jar  to  remain  after  the 


Electrodes  for  Applying  Static  Electricity. 


coating  on  the  outside  of  the  jar  does  not  freeze.  If 
moisture  does  not  collect  on  the  jar,  it  shows  the  machine  is 
dry,  and  if  the  machine  refuses  to  work,  it  is  a  positive 
proof  that  something  besides  moisture  is  interfering  with 
its  operation. 

Several  pounds  of  thoroughly  baked  calcium  chloride,  placed 
on  trays  within  the  case  of  the  machine,  with  doors  tightly 
secured,  will  absorb  the  moisture  as  it  enters  the  case.  The 


78 


PRACTICAL   ELECTRO-THERAPEUTICS. 


condition  of  the  chloride  will  indicate  the  necessity  of  rebak- 
ing  it  (which  should  be  done  in  a  slow  oven.  It  must  not 
be  boiled). 

Ordinary  calcium  oxide  (quicklime)  may  also  be  used  with 
very  satisfactory  results.  In  a  box  made  of  strips  of  wood, 
with  large  opening  all  the  way  round,  place  about  ten  pounds 
of  calcium  oxide,  and  cover  it  well  with  several  thicknesses 


Grounding  the  Static  Machine  by  Wire  Attached  to  Upper  Part  of 
Case,  Which  Can  Easily  be  Transferred  to  Opposite  Pole. 

of  muslin  to  prevent  the  dust  from  getting  on  the  plates  of 
the  machine.  Caustic  soda  or  caustic  potash  may  also  be 
used.  The  author  prefers  sulphuric  acid,  c.  p.  (ten  pounds) 
placed  in  a  dish  in  one  end  of  the  case.  It  keeps  the  case 
dry  for  a  longer  period  of  time  than  any  other  measure,  and 
has  been  found  to  be  most  reliable  in  moist  and  warm 
climates. 

A  hygrometer  will  be  found  of  value  in  determining  the 


PRACTICAL   ELECTRO-THERAPEUTICS.  79 

condition  of  the  machine  from  month  to  month,  for  under  the 
same  relative  atmospheric  conditions  the  discharge  from  a 
machine  is  uniform,  or  the  machine  is  not  in  a  normal  condi- 
tion. 

Frequently  the  shellac  on  the  surfaces  of  the  rotating 
plates  needs  to  be  renewed.  This  may  be  done  by  applying 
over  the  rotating  plates,  a  mixture  of  white  shellac  dissolved 
in  alcohol  to  a  syrupy  consistency.  D-ry  the  machine  out 
thoroughly  after  this  performance,  as  it  helps  to  dry  the 
shellac  properly. 

A  basin  of  linseed  oil  placed  in  the  machine  will  absorb 
part  of  the  nitric  acid  generated  in  the  machine. 

Keep  the  machine  well  oiled. 

Ground  the  poles,  connect  with  gas,  water  or  steam  supply 
pipe,  or  drive  two  iron  pipes  into  the  ground  until  they  reach 
moisture.  Two  groundings  are  necessary.  Bring  the  copper 
wire  to  within  short  distance  of  the  machine  along  the  wall 
and  bend  to  terminate  in  a  hook.  Bring  the  other  grounding 
for  the  electrode  neat  the  machine  in  the  same  way.  Ground- 
ing the  machine  is  the  most  important  rudimentary  principle 
in  using  static  electricity.  Always  ground  the  electrode 
and  prime  conductor  not  in  use. 

The  object  in  grounding  is  to  create  the  lowest  possible 
pressure  at  this  pole,  while  the  highest  pressure  is  main- 
tained at  the  other.  Without  this  difference  we  can  not  get 
a  current  of  high  voltage. 

The  platform  is  an  essential  part  of  the  static  treatment 
by  insulation  and  in  the  application  of  the  wave  current,  etc., 
or  there  would  be  no  accumulation. 

Place  the  platform  about  two  feet  from  the  machine.  The 
current  is  led  to  the  machine  either  by  means  of  a  shepherd's 
crook  or  an  insulated  cord.  These  may  be  connected  by  a 
chain  with  the  copper  plate,  fifteen  by  sixteen  inches,  under 
the  feet  of  the  patient,  or  by  placing  a  metal  conductor  in 
the  hands  of  the  patient. 

If  the  patient  is  too  near  the  negative  prime  conductor, 
when  the  platform  is  connected  with  the  positive  pole  and 
a  strong  current  of  high  resistance  is  present,  it  may  prove 
disagreeable  to  the  patient.  Place  the  patient  so  that  the 
active  prime  conductor  is  opposite  the  head.  This  avoids 
irritation  of  the  patient  from  woolen  clothing  with  an  oppo- 
site breeze. 


80 


PRACTICAL   ELECTRO-THERAPEUTICS. 


The  patient,  if  a  female,  should  remove  hat  pins,  and 
should  not  use  metal  or  celluloid  hair  pins.  Metal  may 
cause  unpleasant  sensations  and  annoy  timid  patients,  and 
celluloid  pins  have  been  known  to  ignite  from  a  strong 
spray  or  brush  discharge. 

The  current  has  no  effect  on  a  watch. 


Movable  Spray  Over  Solar  Plexus  for  Nausea. 

The  chair  on  the  platform  should  be  devoid  of  all  metals, 
nails  or  ornaments,  as  they  may  prove  very  irritating  and 
annoying  to  the  patient. 

In  moving  about  platform  the  operator  should  keep  out  of 
sparking  distance  of  the  patient,  as  an  unexpected  spark  may 
greatly  lessen  confidence  of  patient,  or  cause  him  to  cease 
treatment,  as  many  have  found  out  to  their  regret. 

When  the  current  is  interrupted  by  sparks  in  any  part  of 
the  circuit,  the  brass  plate  under  the  feet  may  become  dis- 
agreeable to  a  patient  who  wears  shoes  with  thick  soles  or 


PRACTICAL    ELECTRO-THERAPEUTICS.  81 

iron  pegs  in  the  soles.  To  avoid  this  the  conductor  may  be 
held  in  the  hands  of  the  patient. 

If  for  any  reason  the  machine  is  stopped  during  the  admin- 
istration of  treatment  and  again  started  or  the  speed 
accelerated,  the  passage  of  a  single  or  infrequent  long  sparks 
at  the  spark-gap  may  produce  unpleasant  sensations  of  shock. 

If  the  noise  of  the  discharging  rod  annoys  the  patient,  make 
use  of  the  muffler. 

As  the  polarity  of  the  machine  may  change  from  side  to 
side  while  at  rest  or  in  taking  a  new  charge  without  apparent 
cause,  it  is  necessary  to  have  some  manner  of  determining 
which  is  which.  With  sliding  poles  about  an  inch  apart, 
start  the  machine  slowly  and  observe  the  pole  from  which 
it  passes.  This  is  the  positive  pole. 

With  a  spark  stream  about  five  inches  long,  ground  one 
electrode.  If  it  is  the  positive  pole  the  current  will  be  con- 
ducted to  the  earth  and  the  spark  stream  will  stop;  if  the 
negative  pole  is  grounded,  the  stream  will  continue. 

In  a  dark  room,  polarity  may  be  determined  by  looking 
at  the  plates.  Only  a  few  stars  are  found  on  the  metal  comb 
on  the  positive  side,  while  a  heavy  ultra-violet  stream  will 
be  seen  on  the  negative  side. 

When  a  machine  changes  polarity  every  week  or  so,  or 
even  while  in  operation,  there  is  a  loss  of  charge  by  leakage, 
and  shows  that  the  machine  should  be  cleaned  and  the  case 
dried. 

Polish  the  metal  surface  of  the  electrodes  and  ball  on  sliding 
rods,  so  that  the  current  glides  off  as  smoothly  as  though 
lubricated.  A  chamois-skin  is  essential  in  keeping  the 
electrode  in  good  condition.  Every  irregularity  interferes 
with  a  full  flow  of  the  current. 

Every  static  machine  will  require  renovation  according  to 
the  amount  of  work  done  and  care  taken  of  it. 

After  thoroughly  cleaning  and  drying  the  plates  it  will  be 
well  to  cover  the  revolving  plates  with  a  coating  of  the  best 
varnish. 

The  metal  parts  inside  the  case  should  also  be  lacquered. 
This  is  a  difficult  thing  to  do  without  taking  the  machine 
apart.  When  properly  cleaned  the  machine  is  as  good  as  a 
new  one. 

In  static  treatments  we  do  not  make  contact  with  two 
poles,  for  if  we  do,  then  we  either  destroy  the  essential 


82 


PRACTICAL   ELECTRO-THERAPEUTICS. 


accumulation  if  the  patient  is  on  the  platform,  or  we  must 
use  a  Leyden  jar  current,  which  is  the  same  as  the  faradic, 
and,  like  it,  it  has  no  electrolytic  or  osmotic  action.  On 
the  contrary,  charged  with  but  one  pole,  the  pull  is  not 
inward  but  outward  to  the  grounded  pole,  on  account  of  the 
attraction  by  opposite  electricity. 


Treating  Sprained  Thumb  by  Wave  Current. 

To  be  a  successful  operator,  it  is  necessary  to  know  the 
sensation  produced  by  the  various  modes  of  treatment,  and 
how  to  differentiate  between  a  tonic,  a  sedative  and  a  coun- 
terirritant  or  rubefacient  effect.  Rudimentary  skill  in  static 
application  is  quickly  acquired  through  self-treatment,  but 
skill  can  be  acquired  only  by  carefully  studying  the  action 
of  the  current  on  different  tissues  and  the  varying  resistance 
offered  by  different  fabrics.  Discriminate  dose  regulation 
by  practice  on  yourself.  The  static  current  is  not  limited 
to  one  method  of  application,  and,  as  in  drugs,  the  therapeutic 
results  mav  be  obtained  in  more  wavs  than  one. 


PRACTICAL   ELECTRO-THERAPEUTICS.  83 

The  action  of  local  static  applications  exerts  a  powerful 
influence  far  beyond  the  area  on  which  it  falls.  The  surface 
stimulation  of  sensory  nerves,  as  has  been  demonstrated,  is 
transported  to  central  ganglia,  where  it  produces  lasting 
effects. 

You  must  be  able  to  vary  the  speed  of  your  machine  or 
you  can  not  vary  your  dose  regulation,  which  you  must,  as 
you  would  a  dose  of  morphine  or  strychnine. 

INSULATION. 

Seat  the  patient  on  the  platform  and  connect  the  positive 
prime  conductor  with  the  platform  by  means  of  a  conducting 
rod  or  cord,  and  connect  the  patient's  feet  with  the  conductor 
by  means  of  the  chain  and  foot  plate  or  by  .holding  the  con- 
ductor in  the  hand.  Ground  the  negative  pole.  After  the 
plates  have  been  set  in  motion  separate  the  poles  as  widely 
as  possible. 

Positive  Insulation. — The  current  of  electricity,  being  a 
mode  of  motion,  is  conducted  through  the  air  in  contact  with 
the  skin,  and  disassociates  its  molecular  structures,  upon  the 
same  principle  as  if  a  drop  of  oil  were  placed  in  a  glass  of 
water  and  stirred  rapidly  enough  to  break  it  up  in  minute 
particles.  The  more  rapidly  it  is  stirred,  the  finer  the 
decomposition  or  disassociation  of  the  structure.  The  large 
quantity  of  free  oxygen  or  ozone  thus  developed  is  rapidly 
absorbed  by  the  tissues.  In  consequence  of  this  it  has  a 
wide  range  of  usefulness  as  a  tonic,  especially  in  tuberculosis. 
We  can  appreciate  this  when  we  consider  that  all  the  various 
chemical  activities  occurring  in  the  body  are  combinations 
of  oxygen  with  food  supply. 

Positive  electrification  is  more  energetic  than  negative, 
on  account  of  its  higher  voltage,  and  is  correspondingly  more 
valuable  as  a  therapeutic  agent. 

With  positive  insulation  the  negative  breeze  often  proves 
very  irritating,  and  may  be  moderated  by  diminishing  the 
resistance,  removing  heavy  woolen  clothing,  etc.  It  is  not 
irritating  through  cotton  material  or  on  the  bare  skin. 

Negative  insulation  has  no  advantages  over  positive  insula- 
tion, with  the  exception  that  the  negative  breeze  is  seldom 
irritating  from  without,  and  sparking  seldom  occurs,  and  for 
this  reason  it  may  be  used  with  nervous  and  easily  excited 
patients. 


84 


PRACTICAL   ELECTRO-THERAPEUTICS. 


Patients  enfeebled  by  recent  illness,  cases  of  anemia, 
neurasthenia  and  patients  extremely  susceptible  to  the 
weather  on  account  of  their  debilitated  condition  frequently 
improve  very  rapidly  under  this  treatment.  When  a  person 
is  "run  down,  overworked  and  fagged  out  completely,"  but 
is  unable  to  leave  business  and  seek  rest,  this  form  of  treat- 
ment is  of  undoubted  benefit,  as  it  takes  a  great  load  off 


Static  Insulation. 


the  already  overworked  organs.  The  effect  is  less  marked  as 
we  approach  the  normal  state.  It  is  applicable  to  any  age, 
from  the  infant  to  the  extreme  limit  of  old  age. 

In  cases  of  extreme  nervousness  and  apprehension,  no 
attempt  should  be  made  to  do  more  than  have  the  patient  sit 
upon  the  platform  in  a  condition  of  charge.  This  is 
especially  true  if  a  marked  hysterical  element  enters  into  the 
case. 


PRACTICAL   ELECTRO-THERAPEUTICS. 


85 


BREEZE. 

The  breeze  of  static  electricity  is  a  current  of  electrified 
air  thrown  from  the  point  or  points  of  an  electrode  to  the 
body  of  the  patient.  The  density  of  the  current  depends  on 
the  surface  of  the  electrode  and  the  number  of  metallic  points 
implanted.  The  energy  of  the  breeze  depends  on  the  speed 


Stationary  Breeze  to  Forehead. 


of  the  revolving  plates,  the  state  of  the  air,  the  condition  of 
the  clothing  and  the  manipulation  of  the  electrode.  The 
patient  may  be  positively  or  negatively  insulated;  both  the 
positive  and  the  negative  breeze  are  bland  and  sedative  when 
applied  to  the  bare  skin. 

Where  insomnia  is  due  to  the  irritation  of  auto-intoxica- 
tion, the  patient  when  placed  under  the  influence  of  the  static 
head  breeze  will  frequently  go  to  sleep  in  from  five  to  ten 
minutes,  and  remain  asleep  while  the  soothing  influence  of 


86 


PRACTICAL    ELECTRO-THERAPEUTICS. 


the  static  breeze  continues,  and  frequently  for  hours  after- 
ward. 

The  breeze  may  be  either  movable  or  stationary.  The 
movable  breeze  is  usually  the  point  or  brush  electrode  in  the 
hand  of  the  operator,  and  may  be  moved  back  and  forth  with 
a  slow  or  rapid  motion  over  the  region  to  be  treated. 

Through  cotton,  linen  fabrics  and  on  the  bare  skin  the 
negative  breeze  is  cool  and  sedative,  but  applied  through 


Head  Breeze  in  Adjoining  Room  for  Insomnia. 

woolen  fabric  it  may  be  made  a  stimulant  and  counterirritant, 
reddening  the  skin  and  causing  sensations  of  warmth  which 
may  last  for  some  time,  and  may  be  made  to  blister  in  a  few 
minutes,  if  this  effect  is  desired.  Cold  extremities,  sluggish 
circulation,  hepatic  pain  and  pelvic  pain  frequently  yield  to 
this  form  of  treatment.  Irritant  effects  may  be  increased 
by  increasing  the  motion  of  the  plates  and  making  an  interrup- 
tion between  the  prime  conductor  and  the  patient.  When  the 
hair  is  thick,  the  negative  head  breeze  may  be  unbearable. 


PRACTICAL   ELECTRO-THERAPEUTICS. 


87 


Metal  ornaments  and  corset  steels  may  cause  burning  or  dis- 
agreeable sensations  with  the  negative  breeze. 

SPRAY. 

The  static  spray  differs  from  the  breeze  only  in  the  closer 
proximity  of  the  electrode  to  the  patient.  It  is  more  energetic 
in  its  action  and  therapeutic  qualities  than  the  breeze.  It 


Movable  Negative  Spray  Over  Kidneys. 

intensifies  all  the  effects  produced  by  the  breeze.  It  is  more 
sedative  and  calming  when  these  effects  are  desired,  and  more 
irritating  and  rubef acient  when  the  latter  effects  are  indicated. 
When  powerfully  applied  and  concentrated  with  skill,  it 
relieves  a  great  variety  of  painful  conditions. 

Owing  to  its  simplicity  and  mildness,  profound  and  unique 
effects,  this  mode  of  treatment  deserves  careful  study,  as 
operative  technique  plays  an  important  part  in  the  com- 
fort of  this  application. 


g8  PRACTICAL   ELECTRO-THERAPEUTICS. 

With  the  indifferent  pole  grounded,  the  patient  may  be 
either  positively  or  negatively  insulated,  though  it  is  well  to 
bear  in  mind  that  the  negative  spray  is  more  irritating  than 
the  positive.  To  obtain  a  counterirritantor  rubefacient  effect, 
the  parts  should  be  covered  by  woolen  clothing  or  material 
of  the  same  character.  The  irritating  effect  may  be  increased 
with  the  speed  of  the  plates  by  interrupting  the  spray  or 
bringing  the  electrode  so  close  to  the  body  that  fine  needle-like 
sparks  will  mingle  with  the  spray.  The  spray  acts  as  a 
sedative  only  on  those  parts  which  it  reaches  en  masse  and 
without  friction. 


These  Shunt  Terminals  Permit  the  Giving  of  Positive  Spray  with 
Little  Danger  of  Spark. 

In  giving  the  spray,  study  the  point  of  your  electrode, 
which  will  warn  you  when  to  avoid  a  spark  which  might 
disturb  the  patient.  In  giving  spray,  avoid  all  projections, 
such  as  the  various  angles  of  the  face,  that  might  draw  off 
a  spark.  Slowly  move  up  to  where  the  violet-pencil  discharge 
pours  full  upon  the  point  you  wish  to  treat. 

As  it  is  not  necessary  to  use  the  platform  when  we  connect 
the  spray  electrode  with  the  machine,  we  are  able  to  treat 
timid  patients  in  another  room.  We  can  do  this  by  placing 
a  heavily  insulated  wire  through  the  wall  and  connecting  the 
cord  from  the  machine  to  this.  We  connect  our  electrode 
cord  to  this  wire,  which  has  a  hook  in  our  room.  The 
current  may  be  intensified  by  placing  the  patient  on  an  insu- 
lated metal  plate  connected  with  a  gas-pipe,  etc.  (A  large 
piece  of  sheet  rubber  may  be  placed  beneath  the  metal.) 

Cataphoresis  is  an  impossibility  with  static  electricity. 
The  action  of  the  static  spray  in  hastening  absorption  of 
local  applications  to  the  skin  explains  what  was  considered 
cataphoresis  by  many. 

The  positive  breeze  or  spray,  on  account  of  its  cooling, 
agreeable,  as  well  as  bland  and  sedative  qualities,  is  very 
grateful  to  the  patient  and  may  rapidly  relieve  such  painful 
conditions  as  neuralgias,  muscular  rheumatism,  hysteria, 


PRACTICAL   ELECTRO-THERAPEUTICS. 


89 


painful  inflammatory  conditions  and  nervous  headaches. 
The  headaches  not  reached  by  the  static  breeze  are  usually 
due  to  some  active  continuous  cause,  such  as  anemia,  neu- 
rasthenia, dyspepsia  due  to  malnutrition,  etc. 

The  ozone  generated  by  this  mode  of  treatment  exerts  a 
beneficial  effect  on  mild  cases  of  pulmonary  tuberculosis.  It 
must  be  borne  in  mind  that  the  decomposition  of  the  atmos- 
phere results  in.  the  production  not  only  of  ozone,  but  also 
of  nitric  acid,  which  is  an  irritant.  Either  of  these  sub- 
stances would  undoubtedly  destroy  bacilli,  if  brought  in 


Static  Breeze  in  Neighboring  Room. 

contact  with  them.  These  substances  can  be  best  localized 
by  means  of  a  stationary  spray  (from  a  wooden  ball  elec- 
trode) so  placed  as  to  give  him  the  benefit  of  the  decomposed 
air  by  inhalation. 

The  sedative  positive  spray  finds  a  large  field  of  usefulness 
in: 

1.  Acute  rheumatism. 

2.  Acute  swelling  of  joints. 

3.  Lingering  pains  of  subacute  rheumatism. 

4.  Simple  conjunctivitis. 

5.  Simple  laryngitis. 


90  PRACTICAL   ELECTRO-THERAPEUTICS. 

6.  Simple  coryza  and  hay-fever,  where  the  antiphlogistic 
action  dries  up  excretions  of  a  serous  or  suppurating  nature. 

7.  In  nausea,  spraying   the  region   over  the  solar   plexus 
and  pneumogastric  nerve  frequently  brings  hasty  relief. 

8.  It  removes  heat  and  itching  from  superficial  inflamma- 
tions, eruptions  and  burns. 

9.  It  relieves  the  itching  mucous  tissues  of  the  mouth  from 
which  diseased  teeth  have  been  extracted. 

10.  It  not  only  relieves  pain,  but   hastens   the   process  of 
repair    in    fractured    bones    by    relieving    the   condition   of 
stasis. 

The  static  negative  spray  may  be  used  wherever  a  coun- 
terirritant  is  indicated,  and  is  especially  efficacious  in: 

1.  Grip  and  malaria;  this  spray  over  the  liver,  spine  and 
spleen  frequently  accomplishes  great  good. 

2.  Impaired  sensation. 

3.  Chronic  torpor  of  certain  tissues. 
4..  Cold  extremities. 

5.  Deranged  circulation. 

6.  Bronchitis. 

7.  Injuries. 

8.  Pleurisy. 

9.  Nausea,  etc. 

A  hot  spray  over  the  course  of  a  nerve  is  very  effective 
in  relieving  an  attack  of  neuritis  and  affords  prompt  and 
wonderful  relief  in  cases  of  gastralgia,  cardialgia,  nephralgia, 
ovaritis  and  neuralgia  of  the  liver  so  common  in  diabetes. 

In  treating  an  attack  of  neuritis  or  neuralgia  of  the  face 
or  hands  it  is  well  to  cover  the  parts  with  a  flannel  cloth,  as 
the  skin  is  a  very  poor  conductor  and  the  tendency  is  to  a 
dissipation  of  the  charge. 

The  brush  discharge  is  a  discharge  similar  to  the  spray,  a 
wooden  (soft  maple,  white  wood)  ball  or  point  electrode  is 
used  on  the  grounded  pole,  as  it  delivers  a  fine  discharge 
without  any  disrupted  qualities  as  sparks.  (The  electrode 
may  be  frequently  soaked  in  water,  as  the  discharge  becomes 
less  vigorous  when  it  becomes  dry;  heating  the  electrode 
during  cold  weather  increases  the  effect  of  the  discharge.) 

The  intensity,  volume  and  effect  of  this  discharge  vary 
with  the  speed,  capacity  of  the  machine,  nature  and  size  of 
the  electrode,  character  of  the  patient's  clothing  and  the 
atmospheric  conditions.  The  effect  of  the  brush  discharge 


PRACTICAL  ELECTRO-THERAPEUTICS. 


91 


on  a  wet  surface  or  on  wet  clothing  is  entirely  lost.  Cotton 
or  linen  impairs  its  action,  while  woolen  clothing  over  the 
surface  to  be  treated  favors  strong  effects. 

When  applied  for  a  long  period  the  effect  is  at  first  rube- 
facient,  and  later  vesicant,  finally  producing  painful  blisters. 


Connections  for  Giving  Positive  or  Negative  Crown  Breeze. 

Open  surfaces  must  be  avoided,  as  most  of  the  current  will 
enter  the  raw  spot  and  cause  pain. 

This  discharge  lessens  local  hyperemia  and  congestion  by 
contracting  the  arterioles,  thereby  relieving  pain  and  dimin- 
ishing swelling  to  a  marked  degree.  Metabolism  is  increased 


Juettner's  Prosphoric  Static  Electrode. 

in  the  end  organs,  and  healthy  restorative  action  is  induced. 
The  nature  of  this  electrical  discharge  decomposes  the 
atmosphere,  developing  ozone  in  so  close  a  proximity  to  the 
skin  or  diseased  tissue  as  to  render  the  site  of  application 
distinctly  aseptic  by  oxidizing  organic  life.  It  is  owing  'to 
this  property  of  the  current  that  lupus,  eczema,  herpes, 


PRACTICAL  ELECTRO-THERAPEUTICS. 


acne  and  scabies  are  wonderfully  relieved  and  cured  by  its 
action.  Swellings  associated  with  fractured  bones,  sprains 
and  abscesses  rapidly  disappear.  It  has  a  wide  field  of  use- 
fulness in  cases  of  gastralgia,  neuralgias  of  a  superficial 
nature,  coccygodynia,  pruritus  and  myalgias. 

Ozone  sprays  heal  granulations  and  deodorize  fetid  odor 
in  sores. 

A  high  frequency  current  may  be  obtained  from  the  static 


Positive  Spray.    Ulcerated  Surface  in  Mouth. 

machine  by  employing  vacuum  tube  electrodes.  The  dis- 
charging spark-gap  is  essential,  for  without  it  there  is  no 
appreciative  interruption,  no  frequency.  The  spark-gap 
between  the  balls  of  the  discharging  rod  must  be  regulated 
to  the  condition  treated.  It  is  not  necessary  to  insulate  the 
patient  as  in  other  static  modalities. 

In  the  treatment  of  the  air  passages,  medicated  air,  or 
medications  held  in  suspension  by  the  air,  are  used  with 
more  or  less  success,  even  with  the  very  simplest  forms  of 


PRACTICAL   ELECTRO-THERAPEUTICS. 


93 


treatment,  such  as  sucking  the  air  through  a  wash  bottle 
containing  the  medication,  or  the  inhalation  of  a  medicated 
spray  from  an  atomizer  or  a  nebulizer.  Nebulizers  are  used 
with  more  success  for  inhalations,  because  the  substances 
held  in  suspension  by  the  air  are  broken  up  into  very  much 
smaller  particles  than  from  an  atomizer.  In  fact,  there  is 
considerable  competition  between  manufacturers  of  nebulizers 
as  to  which  nebulizer  breaks  up  the  medication  the  finest, 
producing  a  more  perfect  vapor  for  inhalation.  The  finer 
the  particles  held  in  suspension  by  the  air,  the  finer  or  smaller 
are  the  air  passages  that  may  be  reached. 


Hughes  Ionizer  in  Use. 

The  Hughes  Ionizer  is  peculiarly  adapted  for  use  with  a 
nebulizer,  because  the  medicated  air  or  vapor,  in  passing 
through  the  air  chamber  of  the  Ionizer,  is  acted  upon  induct- 
ively by  the  excited  vacuum  bulb,  and  undergoes  changes 
which  still  further  subdivide  the  particles  held  in  suspension 
by  the  air  to  such  an  extent  that  they  are  rendered  invisible. 
Connect  the  Ionizer  to  a  nebulizer  and  it  will  be  noticed 
before  the  current  is  turned  on  or  the  vacuum  bulb  of  the 
Ionizer  is  excited  that  a  cloud  of  vapor  will  appear  from  the 
opening  of  the  Ionizer  from  which  inhalations  are  to  be  made, 
but  as  soon  as  the  current  is  turned  on  and  the  vacuum  bulb 


94  PRACTICAL  ELECTRO-THERAPEUTICS. 

of  the  Ionizer  is  excited  the  cloud  of  vapor  almost  or  entirely 
disappears^  showing  that  the  medication  held  in  suspension 
by  the  air  is  so  completely  subdivided  and  incorporated  with 
the  air  that  when  inhaled  it  will  reach  the  very  finest  rami- 
fications of  the  air  passages. 

If  the  medication  used  is  alkaline  in  reaction  it  will  com- 
pletely neutralize  the  acid  effects  indirectly  arising  from 
excited  nitrogen  combining  with  hydrogen,  thus  the  ozone, 
which  is  produced  in  large  quantity,  may  be  utilized  without 
any  of  the  irritating  effects  as  experienced  in  the  use  of 
ordinary  ozone  generators.  This  is  easily  demonstrated  by 
sucking  air  through  the  Ionizer  without  the  use  of  any 
medication  of  an  alkaline  character.  It  will  be  noticed  that 
considerable  irritation  is  produced,  invariably  causing  the 
patient  to  cough,  but  as  soon  as  the  air  sucked  through  the 
Ionizer  by  the  patient  is  made  to  contain  medication,  such 
as  bicarbonate  of  soda  or  borax,  the  irritating  effects  of  the 
inhalation  entirely  disappear.  Deep,  full  inhalation  may 
then  be  made  without  the  slightest  irritation. 

The  wide  range  of  usefulness  covered  by  a  nebulizer  is 
very  greally  increased  by  the  use  of  a  Hughes  Ionizer,  and 
although  the  instrument  is  yet  new,  most  gratifying  reports 
are  made  by  those  using  the  instrument,  as  they  get  results 
promptly  and  in  conditions  which  did  not  yield  to  treatment 
without  the  Ionizer. 

SPARK. 

Place  the  patient  on  the  insulated  platform,  the  indifferent 
pole  being  grounded.  Before  starting  the  machine,  pull  the 
sliding  poles  far  apart.  As  a  rule  it  is  not  necessary  to 
connect  the  patient  with  the  prime  conductor,  as  mere  insu- 
lation of  the  current  on  the  platform  is  enough  to  give 
patient  all  the  spark  he  can  stand. 

Use  the  grounded  electrode  for  administration,  as  the 
spark,  direct  from  the  machine,  is  used  only  in  cases  of 
marked  anesthesia.  The  spark  is  administered  by  throwing 
the  metallic  ball  or  point  electrode  with  a  quick  movement 
to  a  point  near  the  body,  so  that  a  disruptive  discharge  or 
spark  takes  place.  The  percussive  discharge  is  a  single 
discharge,  thick,  strong  and  clear  cut.  If  the  patient  be 
negatively  insulated,  the  spark  is  thicker,  because  the  low 
voltage  of  the  negative  platform  permits  more  current  to 


PRACTICAL   ELECTRO-THERAPEUTICS.  95 

accumulate  on  the  positive  electrode  before  it  breaks  the 
tension.  The  positive  spark  is  milder  in  sensory  effect  and 
less  penetrating  than  the  negative  spark. 

The  spark  is  varied  in  size  by  the  electrode;  exactly-  as 
large  or  small  bottles  hold  varying  quantities,  so  varying 
sizes  of  electrodes  hold  greater  or  less  quantities  of  electricity. 
The  spark  depends  on  the  charge  and  capacity  of  electrode. 
The  potential  quantity  of  electricity  is  analogous  to  the 


Posture  in  Treating  Lumbago. 

quantity  of  material  fluid.  The  electricity  resides  on  the 
surface  of  the  electrode,  and  it  is  absolutely  essential  that 
the  electrode  be  polished  and  smooth,  as  the  current  tends  to 
divide  and  fly  off  the  minute  projecting  points  and  edges. 
The  size  and  length  of  the  spark  are  indicated  by  the  depth 
of  the  lesion  and  its  chronicity. 

A  large  ball  electrode  is  rarely  used  except  in  cases  of 
impaired  sensation. 


96 


PRACTICAL   ELECTRO-THERAPEUTICS. 


It  is  rarely  advisable  to  administer  sparks  at  a  first  sitting, 
if  the  patient  is  a  stranger.  After  several  treatments  the 
system  acquires  a  degree  of  tolerance  and  confidence. 

The  spark  is  not  always  found  disagreeable,  and  a  sur- 
prising number  of  patients  will  claim  to  really  enjoy  mild 
and  skilfully  directed  sparks. 


Posture  in  Treating  Sciatica. 

Sparks  should  be  administered  with  some  sense  of  regu- 
larity as  to  time  and  rhythm,  for  the  tissues  soon  learn  to 
anticipate  the  next  spark. 

Sparks  rapidly  following  one  another  on  the  same  spot 
cause  unnecessary  pain,  and  should  be  administered  with 
an  interval  of  time  and  change  of  base.  Sparks  should  be 
avoided  on  all  bony  prominences,  as  the  back  of  the  hand, 
the  finger  nails,  the  dorsum  of  the  foot,  etc. 

The  breast,  both  in  male  and  female,  and  particularly  the 
nipple,  is  sensitive  and  should  not  be  struck  with  a  spark 


PRACTICAL   ELECTRO-THERAPEUTICS. 


97 


except  for  sufficient  cause.  The  genitals,  most  of  all,  must 
be  avoided. 

Sparks  on  face,  head  and  breast  must  not  be  applied  unless 
the  machine  is  in  slow  motion. 

Moisture  being  a  good  conductor,  perspiration  or  wet 
clothing  will  conduct  the  electricity  away  and  interfere  with 


Giving  Mild  Spark,  with  Electrode  Not  Grounded,  but  Held  at  a 
Varying  Distance  from  Floor. 

the  action  of  the  best  machine.  Over  wet  garments  place  a 
good  non-conductor;  even  a  newspaper  will  answer  the 
purpose. 

In  administering  sparks  to  the  sole  of  the  foot  see  that 
the  shoe  is  dry,  or  it  will  form  a  spray  instead  of  a  spark. 
If  the  patient  has  on  different  thicknesses  of  clothing,  draw 
off  part  of  the  current  by  means  of  the  foot. 

The  static  spark  is  the  most  active  and  far-reaching  of 
all  static  modes,  and  produces  wide-spread  and  strong 
muscular  contractions,  increasing  molecular  changes  and 

7 


98  PRACTICAL    ELECTRO-THERAPEUTICS. 

thus  aiding  both  general  and  local  nutrition.  Sluggish 
and  weak  muscles  are  given  renewed  vigor;  muscles  and 
tendons  long  contracted  are  loosened  and  relaxed.  Its 
action  is  especially  beneficial  in  toning  up  the  blood-vessels, 
for  it  causes  their  muscular  walls  to  contract  and  empty  the 
stagnant  venous  blood  into  the  general  circulation,  thus 
stimulating  and  regulating  the  functions  of  nerves,  muscles 
and  visceral  organs. 

When  employing  sparks,  be  governed  in  acute  painful 
conditions  by  the  relief  afforded,  taking  care  to  give  no 
unnecessary  sparks,  but  applying  them  directly  to  the 
lesion,  where  they  are  certain  to  be  the  most  painful.  The 
patient  soon  discovers  that  sparks  so  applied  are  followed 
by  greater  relief  and  enters  into  the  spirit  of  the  treat- 
ment. 

In  cases  of  pleurisy,  sparks  in  the  surrounding  tissues 
restore  mobility  and  relieve  pain. 

In  bronchitis,  mild  sparks  promote  expectoration  and 
shorten  the  attack  very  markedly.  In  other  affections  of 
the  lung,  it  increases  the  capacity  of  the  lung  for  oxygen  by 
its  effect  on  the  respiratory  muscles  and  centers. 

In  treating  nerve  affections,  cause  the  muscles  to  be 
moved  about  and  held  in  those  positions  that  cause  most 
pain,  and  then  give  the  percussive  spark. 

Under  the  influence  of  long  percussive  sparks,  thickened 
and  edematous  tissues,  acute  or  chronic  indurations  and 
exudations  are  often  resolved  and  soon  absorbed,  causing 
the  tissues  to  take  on  a  healthy  aspect. 

In  fractures,  sparks  thrown  into  the  joints  will  increase 
the  mobility  very  markedly. 

In  chronic  inflammation  of  joints,  thick  percussive  sparks 
into  the  joint  are  very  effective. 

In  locomotor  ataxia  give  spark  to  plantar  region  of  the 
foot.  The  number  of  sparks  needed  will  depend  on  the 
tissues.  It  should  be  continued  until  they  respond  and 
become  warm. 

It  must  not  be  forgotten  that  there  are  people  with  hyper- 
sensitive skins  as  well  as  anesthetic  skins,  and  a  small  spark 
will  sometimes  produce  excruciating  pains. 

In  old  age,  sparks  applied  all  over  the  body  have  a  won- 
derful rejuvenating  and  tonic  effect  on  the  body,  and  are  a 
great  aid  to  any  medicine  the  patient  may  be  taking. 


PRACTICAL    ELECTRO-THERAPEUTICS. 


99 


In  patients  with  sluggish  circulation,  the  sparks  are  fre- 
quently followed  by  a  mottled  appearance  of  the  skin,  which 
may  persist  for  two  or  four  hours. 


FRICTIOX  SPARK. 


The  friction  spark  may  be  used  during  humid  weather 
when,  the  direct  spark  will  not  work.  The  patient  may  be 
positively  or  negatively  insulated,  and  the  active  pole  may 
be  used  either  direct  or  grounded. 


Movable  Spray  in  Rheumatism. 

The  electrode  is  rubbed  over  the  surface  of  the  clothing, 
or  the  electrode  may  be  covered  with  flannel  and  then  rubbed 
over  the  bare  skin.  The  discharge  consists  of  a  number  of 
fine,  minute  sparks,  varying  from  one-fourth  to  one-eighth 
inch,  according  to  the  thickness  of  the  clothing.  The  posi- 
tive spark  is  always  milder  than  the  negative,  because  it  is 
given  with  negative  insulation. 


100 


PRACTICAL    ELECTRO-THERAPEUTICS. 


Place  the  electrode  before  starting  the  machine  and  separ- 
ate the  sliding  poles  gradually  until  the  desired  effects  are 
produced. 

The  metallic  ball  electrode  is,  as  a  rule,  preferable  to  the 
roller  electrode,  whose  movements  are  restricted,  and 
which  does  not  slide  freely  in  all  directions  as  does  the  ball 
or  blunt  electrode,  neither  does  it  fit  into  the  angles  and 
depressions  where  you  may  wish  to  use  it. 


Wave  Current.     Electrode  Under  Feet. 

Friction  sparks  have  marked  counterirritant  and  rubefa- 
cient  effects,  and  may  be  used  whenever  counterirritation  is 
indicated. 

Friction  sparks  are  a  splendid  stimulant  to  the  capillary 
circulation  of  the  skin,  and  as  the  fine  sparks  perforate  the 
cuticle  (just  as  a  piece  of  cardboard  is  penetrated  by  being 
placed  between  discharging  rods),  they  hasten  the  absorp- 
tion of  any  medicament  it  is  desirable  to  employ. 

The  influence  of  friction  extends  far  beyond  the  reddened 


PRACTICAL    ELECTRO-THERAPEUTICS.  101 

skin,  and  reflex  pains  are  often  subdued  by  vigorous 
friction  with  the  large  brass  ball  over  the  region  to  which 
the  pain  is  referred.- 

In  paralysis,  anesthesia,  altered  conditions  of  sensation, 
hepatic  and  ovarian  pains,  sparks  are  used  with  a  great  deal 
of  satisfaction. 

During  the  menopause,  sharp  counterirritation  by  friction 
over  the  cervical  spine  as  well  as  around  the  pelvis  gives  a 
great  deal  of  relief. 

Friction  sparks  given  from  a  rapidly  moving  wooden  ball 
electrode  over  the  affected  surface  frequently  give  prompt 
relief  in  rheumatism  for  about  ten  minutes. 

In  treating  the  spine  or  a  larger  surface,  go  over  the 
tissues  rapidly,  and  when  treating  a  small  surface,  pause  at 
short  intervals,  as  the  parts  are  very  painful. 

As  a  counterirritant,  plain  and  simple  static  electricity 
can  not  be  surpassed  by  any  drug  (all  effects  from  slight 
warmth  to  vesication  may  be  had);  and  the  same  principle 
that  applies  to  drugs  applies  equally  well  to  static  electricity. 

Investigation  teaches  that  painful  sensations  travel  along 
paths  of  least  resistance  on  their  way  out  (explaining  reflex 
pains),  and  thus  create  a  most  direct  route  for  the  inward 
transmission  of  counter-electrical  impressions  that  serve  to 
annul  pain. 

Counterirritations  of  peripheral  endings  of  sensory  nerves 
are  transported  to  the  central  nerve  ganglia  and  are  thus 
capable  of  producing  organic  changes;  this  shows  how  fric- 
tion sparks  operate  in  arresting  cord  disease.  If,  however, 
this  relief  does  not  go  beyond  primary  palliation,  the  excit- 
ing cause  has  not  been  reached  by  the  current  and  must  be 
reached  by  some  other  means. 

WAVE  CURRENT. 

Place  the  sliding  poles  in  contact,  ground  the  positive  pole 
and  connect  the  patient  to  the  other  pole.  In  utilizing  this 
current,  strips  of  flexible  metal  (block  tin,  etc.)  or  moist 
electrodes  are  applied  to  the  affected  parts  beneath  the  cloth- 
ing, and  are  connected  to  the  machine  by  means  of  a  flexible 
cord.  Connection  with  the  patient  may  be  made  at  several 
places  at  the  same  time.  The  metal  may  be  fastened  to  the 
cord  by  means  of  a  spring  clip  or  cuff  holder.  If  the 
strip  of  metal  is  applied  to  the  spine  it  is  well  to  place  the 

. 


102 


PRACTICAL   ELECTROTHERAPEUTICS. 


patient  on  a  chair  with  an  extra  high  back.  A  pillow  at  his 
back  will  keep  the  metal  in  snug  position.  The  muscular 
contractions  or  pain  over  the  inflamed  area  will  determine 
the  relative  size  of  the  metal  electrodes  and  the  spark-gap. 
The  current  should  not  be  felt  more  at  one  place  than  at 
another.  It  may  be  necessary  to  moisten  the  surface  when 
contact  is  first  made  to  avoid  stinging  sensations.  Affer 
treatment  has  continued,  the  spark-gap  may  be  lengthened. 


Wave  Current.     Electrode  Over  Cervical  Spine. 

This  may  be  repeated  several  times  during  the  treatment, 
which  usually  lasts  from  twenty  to  thirty  minutes.  The 
question  is  not  how  weak,  but  how  strong  the  current  can 
be  administered  without  pain,  to  get  the  requisite  local  and 
internal  effect  on  tissues  or  organs. 

If  there  is  a  long  spark-gap,  do  not  come  near  the  plat- 
form with  anything  that  may  draw  off  the  current  and  give 
the  patient  a  shock. 


PRACTICAL   ELECTRO-THERAPEUTICS, 


103 


The  tonic  effect  is  in  proportion  to  the  length  of  the 
spark-gap. 

This  is  the  most  useful  of  the  electrostatic  modes  of  treat- 
ment. Its  superiority  lies  in  the  fact  that  it  is  a  one-pole 
current  of  high  or  low  potential,  great  or  small  frequency, 
is  under  perfect  control,  is  painless  during  administration 
and  potent  for  great  good.  The  patient  being  insulated,  he 
is  repeatedly  charged  and  discharged  from  the  surface  of 


Wave  Current.    In  Exercise  of  Wrist,  After  Fracture. 

contact  with  the  electrode,  obtaining  a  local  as  well  as  a 
constitutional  effect  of  general  electrization  peculiar  to  one 
pole. 

In  giving  the  general  wave  current,  remove  the  shoes 
before  putting  the  feet  on  the  plate  or  insulate  the  feet  by 
an  excess  of  resistance  by  means  of  a  magazine  or  other 
paper,  so  that  intolerable  sparks  do  not  annoy  patient's 
feet. 


104  PRACTICAL    ELECTRO-THERAPEUTICS. 

Profuse  perspiration  often  follows  an  application;  this  is 
especially  true  in  patients  whose  skins  are  active. 

It  lessens  hyperemia  and  congestion,  and  relieves  local  pain 
by  relaxing  muscular  spasm.  It  is  very  effective  as  a  stim- 
ulant to  general  metabolism  and  a  regulator  of  disordered 
nutrition  exchange,  and  the  so-called  neuro-vascular  gym- 
nastics frequently  bring  about  results  superior  to  those  of 


Stimulation  of  Spinal  Center  by  Interrupted  Current. 

general  massage,  because  it  reaches  parts  out  of  reach  by 
ordinary  manual  manipulation. 

In  sciatic  rheumatism  we  find  that  intense  vibrations  are 
required  and  the  spark-gap  must  be  opened  to  the  limit  of 
the  patient's  capacity.  Place  one  electrode  over  the  site  ot 
the  nerve  exit  and  another  over  the  ankle.  When  the 
electrode  touches  the  motor  points  it  is  extremely  painful. 
The  spark-gap  must  be  opened  gradually. 

In   neuralgia  and  neuritis  of  whatever  nature  place  the 


PRACTICAL    ELECTRO-THERAPEUTICS.  105 

electrode  over  the  congested  and  hyperemic  spots,  and 
especially  over  the  motor  points  of  the  nerves. 

In  ovarian  neuritis  place  the  electrode  immediately  over 
the  painful  spot,  on  the  abdomen  and  over  the  centers  in 
spine. 

In  paralysis  apply  the  metallic  electrode  to  the  spine  and 
treat  for  about  forty-five  minutes  with  a  large  spark-gap. 

In  asthma  place  the  metallic  plate  over  the  spine  and  chest 
in  front.  Make  the  spark-gap  from  four  to  eight  inches, 
with  an  application  of  thirty  minutes. 

The  wave-current  treatment  is  very  active  and  efficient  in 
cases  of  gastralgia,  angina  pectoris,  liver  and  kidney  affec- 
tions, pelvic  neuritis,  coccygodynia,  irritable  spine,  etc. 


Spark  Muffler. 

In  prolapsus  uteri  or  enlarged  and  hypertrophied  uterus, 
a  metal  bulb  within  the  vagina;  in  prolapse  of  the  rectum 
or  enlarged  prostate,  a  rectal  bulb  appropriately  placed 
within  the  rectum  will  frequently  bring  about  astonishing 
results. 

A  swelling  action  may  be  brought  about  by  placing  the 
ball  electrode  over  the  muscle  we  wish  to  exercise,  and  by 
drawing  the  sliding  rod  just  beyond  full  dosage  and  return- 
ing it  quickly.  This  applies  to  the  muscles  of  the  hand,  leg, 
thigh,  arm,  chest.  This  treatment,  applied  by  means  of  an 
electrode  over  the  perineum,  stimulates  the  secretion,  circu- 
lation, nutrition,  and  the  nerve  energy  is  powerfully  stimu- 
lated. 

By  modifying  our  technique  we  may  get  all  the  vaso-con- 
strictor  effects  of  a  rapidly  interrupted  fine  coil  current. 
The  muscles  can  be. slowly  or  rapidly  contracted,  this  effect 
being  regulated  by  the  distance  between  the  sliding  poles 


106 


PRACTICAL    ELECTRO-THERAPEUTICS. 


and  the  speed  of  the  plates,  manipulation  of  the  electrode 
and  duration  of  contact. 

By  applying  a  very  small  electrode  over  the  eye,  with  a 
small  spark-gap  and  the  machine  in  slow  motion,  we  obtain 
a  wonderful  tonic  effect  for  tired  eyes,  blepharospasm  and 
especially  in  that  condition  accompanying  kidney  affections, 
where  glasses  fail  to  give  any  relief.  A  half  minute's  treat- 
ment frequently  gives  relief  for  twenty-four  hours. 


Leyden  Jar  Current  in  Chronic  Laryngitis. 

The  application  of  this  current  can  be  localized  to  any 
part,  great  or  small.  The  slowly  repeated  powerful  inter- 
ruptions are  exceedingly  stimulating,  while  the  more  rapid 
the  interruptions,  the  finer  and  more  sedative  is  the  effect. 
It  answers  well  for  many  of  the  local  indications  for  sparks, 
while  it  seems  to  lack  little  of  their  power  to  rapidly  remove 
localized  or  deep-seated  pains  in  fibrous  tissues.  It  is  a  com- 
fortable method  which  will  produce  identical  results  in  many 
cases  to  which  sparks  can  not  be  applied. 


PRACTICAL    ELECTRO-THERAPEUTICS.  107 


LEYDEN  JAR  CURRENTS. 

With  the  sliding  poles  closed  and  the  machine  in  motion, 
gradually  draw  apart  the  poles  after  applying  the  electrodes. 
The  passage  of  the  spark  between  the  discharge  rods  is  ac- 
companied by  a  painless  contraction  of  the  muscles  in  the 
legion  covered  by  the  electrode.  Use  a  sponge  electrode 
moistened  in  a  solution  of  bicarbonate  of  soda;  the  sponge 
must  not  be  too  large,  as  it  destroys  the  efficiency  of  the 
current  density,  requiring  too  large  a  spark-gap,  thus  sac- 
rificing rapidity  and  smoothness. 

The  Leyden  jar  current  is  regulated  by  the  speed  of  the 
plates  and  the  distance  between  the  sliding  poles.  Though 
various  sized  jars  may  be  used,  we  can  so  adjust  the  dis- 
tance between  the  poles  as  to  make  the  largest  jars  produce 
practically  the  same  effect  as  the  smallest  jars. 


Electrode  for  Treatins  Chronic  Laryngitis  by  Means  of  Leyden  Jar  Currents. 

If  the  current  causes  pain  over  a  hairy  spot,  lubricate  it 
with  vaseline  or  soap  and  water. 

There  is  no  contrast  of  pole  action  as  in  galvanic  electri- 
city, though  the  positive  pole  has  a  higher  voltage  and  a 
sharper  bite  on  an  abraded  surface. 

Leyden  jar  currents  are  used  in  the  same  manner  and  with 
the  same  electrodes  as  the  faradic  current.  The  difference 
between  the  effect  of  Leyden  jar  currents  and  the  faradic 
currents  on  nerve  and  muscle  is  very  little. 

There  is  scarcely  a  pain  due  to  traumatism,  sprain,  con- 
gestion or  neuritis  that  is  not  benefited  by  the  Leyden  jar 
treatment.  Its  use  is  found  chiefly  in  chronic  cases,  as  in — 

Rheumatism, 

Rheumatic  arthritis,  small  joints, 

Gonorrheal  rheumatism, 

Gout. 


108 


PRACTICAL   ELECTRO-THERAPEUTICS. 


Sciatica, 

Chronic  pharyngitis, 
Chronic  laryngitis. 
Pains  of  various  kinds, 
Circumscribed  burns, 

Poliomyelitis — restores    muscular    tone    and    warmth    to 
entire  limb  and  prevents  arrest  of  bone  growth, 


Leyden  Jar  Current  to  Spinal  Center  and  Solar  Plexus. 

Edema  of  extremities, 

Biliary  lithiasis. 

Occupation  neuroses, 

Chorea, 

Locomotor  ataxia — removes  lightning  pains  and  promotes 
feeling  of  well-being. 

The  author  has  found  that  the  Leyden  jar  current  is  very 
efficacious  in  the  treatment  of  a  number  of  cases  of  relaxed 
kidneys.  The  accompanying  gastric  symptoms,  as  well  as 


PRACTICAL    ELECTRO-THERAPEUTICS. 


109 


the  bearing-down  and  tired  feeling,  frequently  disappear 
after  two  treatments.  Two  sponge  electrodes  about  the 
size  of  the  hand  are  used;  one  is  placed  on  the  back  over  the 
kidneys  and  the  other  over  the  solar  plexus  in  front. 

Many  cases  of  Bright's  disease  are  undoubtedly  due  to 
faulty  digestion  and  chronic  indigestion,  with  the  consequent 
auto-intoxication.  As  these  cases  are  less  violent  than  the 


High-Frequency  Current  in  Appendicitis. 

cases  of  nephritis  following  infectious  diseases,  they  are 
ordinarily  neglected,  and  attention  is  only  drawn  to  the 
actual  condition  present  by  the  mental  and  nervous  irrita- 
bility of  the  patient.  This  condition  is  greatly  improved  by 
local  applications  of  the  induced  current,  one  electrode 
placed  over  the  liver  and  the  other  over  the  kidneys. 

The  author  has  seen  reaction  from  this  form  of  current 
not  obtainable  from  the  strongest  application  obtainable 
from  faradism,  both  coarse  and  fine  wire  coil.  It  may  be 
used  in  the  vagina,  uterus  and  other  internal  cavities. 


110  PRACTICAL    ELECTRO-THERAPEUTICS. 


DOSAGE    OF    STATIC    ELECTRICITY. 

The  dosage  of  current  necessarily  varies  with  the  rapidity 
of  the  revolutions  of  the  plates  and  in  the  manner  of  conduct- 
ing the  current  to  the  patient. 

The  duration  of  treatment  will  depend  on  the  pathological 
condition  presenting  itself.  This  condition  will  indicate 
whether  the  treatment  should  be  repeated  daily,  or  less 
often,  and  whether  the  treatment  should  be  of  a  stimulating 
or  sedative  nature.  It  must  also  be  borne  in  mind  that  a 
stimulating  treatment  for  one  patient  may  act  as  a  sedative 
in  another. 

General  electrification  by  insulation  or  the  wave  current 
usually  requires  from  twenty  minutes  to  one-half  hour. 

A  sedative  treatment,  with  spray  or  breeze,  may  last  from 
ten  to  twenty  minutes. 

Stimulating  and  counterirritating  treatments  must  of 
necessity  be  short  and  last  from  one-half  to  two  minutes. 

Acute  and  painful  diseases  should  receive  daily  treatment 
until  improvement  permits  of  longer  intervals. 

Chronic  cases  must  be  seen  at  least  three  times  a  week. 

An  overdose  or  too  prolonged  treatment  may  be  followed 
by  wearines^  and  a  sleepy  condition,  never  dangerous  and 
always  relieved  by  rest. 


HIGH  FREQUENCY  CURRENTS. 

At  the  present  time  two  classes  of  apparatus  are  in  use 
for  the  production  of  high  potential  currents — the  static 
machine  and  the  various  modifications  of  the  induction  coil 
used  in  X-ray  work,  the  voltage  and  frequency  of  alterna- 


High  Frequency  Electrode. 

tions  of  which  are  still  further  augmented  by  means  of  the 
Leyden  jars  or  Franklin  plate  condensers  that  connect  the 
secondary  windings  of  the  Tesla  coil  or  the  Oudin  resonator. 
The  origin  of  the  currents  seems  to  be  the  external  armature 
of  the  condenser,  but  they  are  dependent  in  a  measure  upon 
the  current  which  charges  the  internal  armature  of  the  con- 
denser. 

The  organism  treated  with  the  high  frequency  current 
receives,  or  at  least  becomes  charged  with,  a  current  of  one 
hundred  thousand  volts,  the  alternations  (first  positive,  then 

ill 


112  PRACTICAL   ELECTRO-THERAPEUTICS. 

negative)  of  which  would  be  the  fabulous  number  of  one 
billion  or  even  higher  per  second. 

When  we  remember  that  the  greatest  number  of  vibra- 
tions that  can  be  appreciated  in  the  production  of  sound  is 
thirty-six  thousand  per  second,  we  will  admit  that  the  term 
high  frequency  is  well  merited. 

The  alternations  of  an  ordinary  Rhumkorff  coil  are  about 


Oudm  Resonator  Attached  to  X-Ray  Coil. 

two  hundred  per  second  and  the  electromotive  force  of  from 
ten  thousand  to  two  hundred  thousand  volts,  while  the  alter- 
nations of  the  high  frequency  currents  are  millions  per  sec- 
ond and  the  electromotive  force  from  one  hundred  thousand 
to  one  million  volts,  this,  of  course,  depending  on  the  means 
employed. 

The  dose  ranges  from  one  hundred  and  fifty  milliamperes 
to  seven  hundred  milliamperes.  With  high  frequency  such 
a  dosage  is  not  at  all  dangerous  if  judiciously  applied,  while 
it  would  be  extremely  dangerous  if  lowered  to  one  hundred 
alternations,  the  usual  rate 


PRACTICAL   ELECTRO-THERAPEUTICS. 


113 


It  must  further  be  remembered  that  the  high  potential  is, 
in  fact,  obtained  at  the  expense  of  the  current,  the  latter 
diminishing  in  proportion  as  the  potential  or  electromotive 
force  is  raised  by  each  successive  step  up  in  the  transform- 
ing apparatus. 

This  current  differs  from  all  others.  The  energy  pro- 
duced is  a  transmitted  vibration  which  is  carried  or  con- 
ducted by  all  solid  substances  (glass  or  hard  rubber  and 


High  Frequency  Current  in  Mastoiditis. 

other  non-conductors),  irrespective  of  their  electrical  con- 
ductivity, and  has  been  compared  to  a  sound-wave  vibration 
which  passes  through  solid  barriers  by  causing  the  particles 
to  vibrate  at  its  own  rate  of  frequency.  It  passes  through 
glass,  though  this  would  resist  the  passage  of  a  continuous 
current  even  if  the  voltage  were  high.  This  explains  the 
apparent  ease  with  which  the  current  passes  through  the 
body  without  giving  rise  to  any  unpleasant  effect,  resulting 
from  the  current  overcoming  the  resistance.  This  current 


114 


PRACTICAL   ELECTRO-THERAPEUTICS. 


produces  a  vitalizing  and  invigorating  effect  without  undue 
stimulation.  It  is  the  nearest  approach  to  vital  force  that 
has  been  produced. 

According  to  Tesla,  the  innocuousness  of  these  currents  is 


Auto-Conduction  with  High  Frequency  Solenoid. 

accounted  for  by  their  not  penetrating  the  body  at  the  point 
of  contact  with  the  electrode,  but  perpendicularly  to  the  skin 
and  equally  over  the  entire  surface  of  the  body. 

D'Arsonval,  on  the  other  hand,  believes  that  the  motor 


PRACTICAL   ELECTRO-THERAPEUTICS.  115 

and  sensory  nerves  are  organized  to  respond  only  to  vibra- 
tions of  a  certain  frequency. 

In  producing  muscular  contractions  a  current  of  from 
twenty  to  thirty  excitations  per  second  is  necessary.  As 
the  number  of  alternations  increases  the  different  contrac- 
tions succeed  in  fusing  together,  the  muscles  becoming 
tetanized  up  to  a  rate  of  vibration  of  from  twenty-five  hun- 
dred to  five  thousand  alternations  per  second.  After  this 
point  has  been  reached  tetany  becomes  less  marked  until  no 
appreciable  sensation  is  experienced. 

When  the  number  of  excitations  reaches  a  height  which  is 
distinguished  as  high  frequency,  all  neuro-vascular  reaction 
is  arrested.  It  is  possible  that  the  motor  and  sensory 
nerves  are  so  organized  as  to  respond  only  to  vibrations  of 
a  determined  frequency,  as  does  the  optic  nerve,  the  ter- 
minations of  which  respond  only  to  undulations  between  four 
hundred  and  ninety-seven  billions  (red)  and  seven  hundred 
and  twenty-eight  billions  (violet)  per  second.  To  the 
infra-red  and  the  ultra-violets  we  are  blind. 

In  the  same  manner  our  auditory  nerves  are  impression- 
able to  vibrations  of  a  certain  rapidity  only.  Musical 
sounds  corresponding  to  vibrations  which  are  too  slow  or 
too  rapid  are  not  perceived. 

The  high  frequency  currents  are  applied: 

First:  By  auto-conduction,  when  the  patient  is  enclosed 
in  a  solenoid  of  copper  wire,  the  ends  of  which  are  con- 
nected with  the  terminals  of  a  high  frequency  coil.  The 
noteworthy  method  of  this  treatment  is  that  the  patient  is 
not  in  contact  with  the  solenoid.  The  solenoid  may  be  large 
enough  to  envelop  the  patient  entirely,  or  large  enough  to 
enclose  an  arm,  a  leg  or  the  chest.  The  passage  of  the 
current  through  the  cage  induces,  by  mutual  induction,  high 
frequency  currents  in  the  tissues  of  the  patient,  which  may 
be  demonstrated  by  a  spark  being  drawn  from  him  at  any 
part.  That  is  to  say,  he  is  saturated  by  being  placed  in  the 
field  of  the  current. 

If  a  lamp  of  twenty  volts  is  used  to  close  the  circuit  of  a 
single  coil  of  thick  wire,  it  illuminates  with  a  brilliant  light 
at  a  distance  of  more  than  three  feet. 

When  placed  in  the  solenoid,  absolutely  no  sensation  is 
experienced,  not  even  the  slightest  muscular  contraction, 
but  on  placing  a  rabbit  within  a  solenoid  traversed  by  high 


11G  PRACTICAL   ELECTRO-THERAPEUTICS. 

frequency  currents,  the  vessels  of  the  ear  become  rapidly 
dilated,  shortly  followed  by  a  contraction  equally  energetic. 
Upon  man  the  effects  are  similar  and  the  skin  soon  becomes 
reddened  and  covered  with  perspiration.  There  is  no 
increase  in  the  body  temperature,  as  excessive  heat  is  lost  by 
radiation  and  evaporation. 

Second:  By  auto-condensation.  This  is  achieved  by 
making  the  patient  one  armature  of  the  condenser,  while  the 
other  consists  of  a  large  sheet  of  metal  placed  on  a  couch 
covered  with  cushions  filled  with  insulating  material,  separ- 
ating it  from  the  patient,  who  holds  in  his  hands  metal 


High  Frequency  Couch. 

electrodes  connecting  with  the  other  end  of  the  solenoid. 
These  handles  should  be  large,  and  firmly  gripped.  The  sen- 
sation of  turning  on  the  current  is  sometimes  that  of  prick- 
ing by  needles  and  pins,  but  usually  passes  off  quickly,  being 
at  no  time  disagreeable.  An  ordinary  armchair  properly 
prepared  may  be  improvised  for  the  purpose  of  condensa- 
tion, lining  the  chair  with  a  metal  sheet  and  placing  the 
patient  on  insulated  cushions.  With  efficient  means,  we 
may  pass  four  to  five  hundred  milliamperes  through  the 
body.  The  patient  is  charged  and  discharged  at  each  oscilla- 
tion of  the  condenser.  The  patient  may  be  connected  with 
only  one  end  of  the  apparatus.  This  is  usually  termed  the 
monopolar  method;  on  account  of  the  enormous  voltage  air 
ceases  to  be  an  insulator  and  the  current  passes  without 


PRACTICAL   ELECTRO-THERAPEUTICS.  117 

conducting  wires.     In  this  method  the  connection  is  taken 
from  the  top  of  a  resonator. 

A  resonator  is  a  piece  of  mechanism  whose  construction  is 
such  that  it  is  capable  of  vibration.  Most  of  us  have  seen 
the  experiment  of  two  tuning  forks,  tuned  to  the  same 
pitch,  s,et  close  to  each  other.  If  one  be  set  in  vibration  by 
a  blow,  the  second  fork  will  start  vibrating  by  itself. 
Because  it  is  vibrating  in  unison  with  the  former,  it  will 
reinforce  the  sound  given  by  the  first  vibrator.  Similar 
phenomena  can  be  produced  in  electrical  apparatus  and  by 
electrical  vibration.  Oudin  was  the  first  to  use  a  resonator 
in  electro- therapy.  His  resonator  was  constructed  of  a 


Body  Diasolenic. 

helix  of  wire  of  suitable  length  and  diameter  appropriate  to 
the  capacity  of  the  inductor.  When  the  solenoid  was  excited 
an  induced  current  appeared  in  the  second  solenoid  or  helix, 
which  by  regulation  could  be  made  to  vibrate  in  unison  with 
the  inducting  solenoid.  When  the  two  solenoids  were 
vibrating  in  unison  a  torrent  of  soft  sparks  would  be  seen 
emanating  from  the  end  of  the  induced  solenoid. 

The  patient  may  be  connected  with  the  solenoid  by  means 
of  two  large  hand  electrodes.  The  current  will  pass  through 
him  by  derivation,  as,  owing  to  the  phenomena  of  self-induc- 
tion, the  solenoid  will  offer  a  great  resistance.  To  obtain  a 
perfect  contact  the  handles  may  be  wrapped  in  wet  flannel 
or  covered  by  a  sponge.  If  the  connection  is  imperfect, 
small  sparks  may  be  observed  to  pass.  If  we  wish  to 


118 


PRACTICAL   ELECTRO-THERAPEUTICS. 


increase  the  area  of  penetration  and  lessen  the  obstruction 
of  the  skin  a  hand  or  foot  bath  may  be  used. 

If  the  contact  with  the  metal  electrode  is  imperfect  a  small 
ulcer  may  be  produced. 

With  local  treatment,  ocular  evidence  will  be  the  guide. 
One  must  always  bear  in  mind  that  local  treatment, 
whether  by  effluve  or  otherwise,  will,  if  persisted  in  for  any 
length  of  time,  cause  inflammation  on  healed  or  healthy 
parts.  The  dosage  requires  as  much  discretion  as  any  other 
therapeutic  measure.  It  is  frequently  noticed  that  patients 
having  pain  at  the  commencement  of  a  sitting  may  find  it 
somewhat  increased  after  energetic  treatment.  Defective 


High  Frequency  Current  in  Acute  Conjunctivitis  Due  to  Cold. 

contact  between  the  apparatus  and  the  patient  may  mean 
unpleasant  sensations  or  even  a  shock. 

Various  shaped  vacuum  glass  tubes  are  used  as  high  fre- 
quency electrodes  and  owe  their  existence  as  electrodes  to 
the  therapeutical  benefits  derived  from  X-ray  treatment. 
In  X-ray  therapy  the  benefits  derived  are  undoubtedly 
due  to  the  high  mode  of  motion  imparted  to  the  rarefied  air 
in  the  X-ray  tube,  and  if  this  high  mode  of  motion  be 
capable  of  producing  such  remarkable  therapeutic  effects, 
will  not  a  similar  mode  of  motion  imparted  to  the  rarefied  air 
of  other  vacuum  tubes  (made  into  various  shapes  and  sizes 
so  to  be  better  adapted  for  treatment)  produce  similar  effects? 

Vacuum  tubes  used  as  high  frequency  electrodes  are 
exhausted  the  same  as  an  X-ray  tube,  as  the  results  obtained 


PRACTICAL   ELECTRO-THERAPEUTICS.  119 

from  their  use  depend  largely  upon  the  degree  of  vacuum; 
and  it  has  been  found  by  experience  that  a  sufficiently  high 
mode  of  motion  should  be  imparted  to  the  rarefied  air  in  the 
tube  to  produce  the  same  color  as  in  an  X-ray  tube  capable 
of  showing  the  bones  in  the  hand. 

The  high  frequency  electrodes  are  excited  by  an  inductive 
action.  Instead  of  conducting  the  current  through  the  tube, 
the  tube  is  provided  with  a  metal  socket  or  clamp  to  which 
one  terminal  of  the  high  frequency  apparatus  is  attached, 
and  the  strength  of  the  inductive  action,  arising  from  the 
tube  when  thus  excited,  depends  upon  the  regulation  of  the 
tension  of  the  current  produced  by  the  high  frequency  appar- 
atus. The  inductive  action  arising  from  the  tube  may  be 
employed  in  various  ways.  The  distinctive  work  to  which 
these  tubes  are  adapted  is  similar  to  that  for  which  the 
X-ray  is  employed,  as  in  treating  abnormal  cell  conditions 
involving  superficial  structures.  The  tubes  are  not  adapted 
to  treating  deep  tissue,  as  with  the  X-ray,  and  do  not  have 
any  effect  upon  the  deep  tissue  of  a  character  like  that 
produced  by  the  X-ray;  therefore  they  may  be  applied 
effectively  in  the  treatment  of  superficial  structures  without 
fear  of  producing  burn,  thus  doing  away  with  the  necessity 
of  protecting  healthy  tissue.  The  only  effect  noticed  from 
ovcrexposure  with  these  tubes  is  a  slight  dermatitis  or  sun- 
burn effect,  and  the  peculiar  energy  emanating  from  these 
high  frequency  tubes,  similar  in  character  to  that  emanating 
from  X-ray  tubes,  may  be  employed  with  success  in  treating 
skin  diseases,  such  as  eczematous  conditions,  acne,  lupus, 
minor  epithelioma,  etc.,  and  in  conditions  involving  the 
mucous  membrane  lining  the  cavities  of  the  body. 

Whatever  is  the  true  solution  or  explanation  for  the  effec- 
tiveness of  this  current,  it,  nevertheless,  remains  a  fact  that 
the  effects  of  the  current  are  felt  deep  in  the  body  and  have 
a  powerful  influence  over  nutrition  in  a  variety  of  ways. 

Experiments  prove  that  we  have  electrical  currents 
traversing  the  body  in  every  direction,  and  that  the  nerves 
are  the  carriers  of  the  current.  It  is  also  true  that  every- 
thing that  acts  as  a  carrier  of  an  electrical  current  vibrates. 
In  perfect  health  the  nerves  are  constantly  vibrating.  The 
rate  of  vibration  is  peculiar  to  the  kind  of  current  carried 
by  the  nerve.  Whenever  a  nerve  loses  its  normal  vibratory 
tone,  its  function  is  impaired,  but  if  placed  under  the 


120  PRACTICAL   ELECTRO-THERAPEUTICS. 

influence  of  the  high  frequency  current  the  patient  is  sub- 
ject to  a  series  of  vibrations,  from  a  few  to  many  millions 
per  second.  This  being  the  case,  every  nerve  in  the  body 
will  find  a  current  to  which  it  will  respond,  and  they  will 
vibrate  accordingly.  A  nerve  once  started  vibrating 
normally  usually  continues  to  do  so,  and  at  least  acts  nor- 
mally while  under  treatment. 

The  strong  tonic  action  on  the  vaso-motor  system  flush- 
ing blood  through  the  capillaries,  opening  sweat  glands, 
relieving  local  congestion,  causes  a  general  sensation  of 
warmth  in  the  body. 

Its  effects  are  double:  stimulation  of  the  trophies, 
sedative  to  the  sensory,  tonic  upon  the  unstriped  muscular 
fibers  locally,  and  cerebro-spinal  and  sympathetic  nervous 
system  generally. 

Respiratory  movements  are  augmented,  and  careful 
measurement  shows  an  increased  absorption  of  oxygen  and 
increased  elimination  of  carbonic  acid  gas.  varying  from 
fifteen  to  thirty  per  cent. 

The  inhibitory  action  of  the  current  is  proven  by  several 
experiments.  Under  its  influence  the  excitability  of  the 
tissues  to  other  stimulation  is  decreased;  local  anesthesia 
occurs  to  the  point  of  penetration,  and  may  last  from  one  to 
twenty  minutes;  the  sensibility  of  the  skin  to  galvanism  and 
faradism  is  greatly  lessened  after  the  passage  of  a  high  fre- 
quency current. 

In  consequence  of  the  great  quantity  of  ozone  generated, 
this  current  has  great  bactericidal  power,  and  has  been 
found  to  destroy  the  toxicity  of  various  toxines. 

These  currents,  after  a  few  minutes'  application,  will  fre- 
quently relieve  the  severest  pains,  and  are  very  effective  in  the 
various  neuralgias. 

Its  action  on  the  mucous  membrane  is  demonstrated  by 
the  disappearance  of  some  cases  of  persistent  hemorrhoids, 
anal  fissures  and  ulcers  of  the  rectum.  It  not  only  allays 
the  irritation,  restores  tone  to  relaxed  fibers  of  blood-ves- 
sels, muscles  and  nerves,  but  restores  the  power  of  the 
impaired  sphincter  and  removes  the  product  of  morbid 
nutrition.  (If  the  cause,  as  torpid  liver,  etc.,  is  still  actively 
present,  the  relief  will,  however,  be  only  temporary.) 

Treating  females  about  the  rectum,  near  the  menstrual 
period,  sometimes  brings  on  a  premature  flow.  This  fact 


PRACTICAL   ELECTRO-THERAPEUTICS.  121 

may  be  utilized  in  treating  virgins  for  delayed  menstruation, 
when  vaginal  manipulation  is  undesirable. 

Nervous  dyspepsia  and  atonic  dilatation  of  the  stomach, 
so  stubborn  to  ordinary  routine  treatment,  yield  readily  to 
treatment  by  high  frequency  currents.  After  a  number  of 
applications,  varying  from  ten  to  twenty,  the  stomach  shows 
a  marked  improvement  in  size  and  position,  and  in  the  pro- 
cess of  digestion.  The  improvement  is  probably  the  result 
of  the  restoration  of  a  normal  circulation  and  blood  supply 
to  the  gastric  glands,  the  consequence  of  the  return  of  the 
stomach  to  its  natural  size  and  position. 

The  improved  circulation  is  probably  due  to  the  tone  given 
to  the  tissues  directly  or  indirectly  through  the  vagus  to  the 
unstriped  fibers  which  constitute  the  muscular  walls  of  the 
stomach.  This  toning  up  enables  the  stomach  to  empty  itself 
after  each  meal.  The  retention  of  imperfectly  digested  food 
ceases,  and  with  this  the  absorption  of  the  abnormal  products 
of  digestion  and  the  consequent  symptoms  of  auto-intoxica- 
tion and  neurasthenia.  One  writer  reports  favorable  results 
in  several  cases  of  chronic  diarrhea  and  dysentery. 

Stout  people  lose  weight  during  the  continuance  of  this 
treatment,  while  the  thin  and  emaciated  gain  steadily. 

Acute  indigestion  is  frequently  relieved  and  the  peristaltic 
condition  of  the  stomach  started  by  a  few  moments'  treat- 
ment over  the  region  of  the  solar  plexus  by  means  of  a  glass 
electrode. 

Atonic  dilatation,  gastric  indigestion  and  malnutrition  in 
infants  have  in  the  author's  experience  responded,  after  a 
few  treatments,  when  other  measures  in  the  hands  of  able 
men  have  failed.  The  treatment  was  applied  by  means  of 
the  vacuum  tube  over  the  solar  plexus  and  over  the  entire 
spine. 

The  high  frequency  current  has  a  powerful  influence  on 
the  mucous  membrane  of  the  stomach  and  the  intestines.  A 
number  of  authors  believe  that  these  parts  of  the  body 
may  be  best  reached  by  applying  one  metal  electrode  to  the 
surface  of  the  tongue  and  another  within  the  anus.  Electri- 
city passing  along  the  lines  of  least  resistance  will  pass 
mainly  along  the  mucous  membrane  of  the  alimentary  tract. 
Especially  good  results  are  claimed  in  gastric  ulcers,  chronic 
gastritis  and  chronic  catarrh  of  the  intestines. 

These   currents  are  effective  in  the  various  inflammatory 


122  PRACTICAL    ELECTRO-THERAPEUTICS. 

conditions,  such  as  epididymitis,  tonsillitis,  beginning  otitis 
media,  and  even  mastoiditis.  Marked  relief  is  frequently 
obtained  after  one  treatment,  where,  before  the  introduction 
of  these  currents,  operation  was  the  only  resort. 

In  tuberculosis  of  the  lungs  the  patient  usually  begins  to 
breathe  more  freely  after  a  local  application  over  the  chest 
of  a  shower  from  the  vacuum  tube  about  one-half  inch 
long. 

The  action  of  high  frequency  by  auto-induction  on  tuber- 
culous guinea  pigs  has  proved  that  an  actual  inflammation 
is  produced  around  the  pulmonary  foci,  and  that  finally  this 
abates  and  leaves  the  lungs  clear  of  bacilli.  High  fre- 
quency currents  in  any  form  are  able  to  produce  modifica- 
tions in  the  tissues  and  make  the  body  cells  more  resistant 
to  the  inroads  of  the  tubercular  bacilli.  The  leucocytes  are 
usually  greatly  increased  during  the  course  of  treatment. 

This  current  is  indicated  in  all  diseases  due  to  errors  of 
nutrition,  as  obesity,  diabetes,  nephritis,  gout,  rheumatism, 
anemia  and  chlorosis.  The  best  results  in  chronic  cases  are 
obtained  by  giving  the  treatment  not  only  over  the  kidney 
and  liver,  but  over  the  whole  body.  The  duration  of  the 
treatment  may  be  from  a  few  moments  upward,  according 
to  the  subjective  symptoms.  A  patient  overdosed  may  feel 
a  certain  degree  of  lassitude,  lasting  more  or  less  for  several 
hours,  .or,  on  the  other  hand,  may  feel  brighter  or  invig- 
orated. The  actual  dose  must  be  capable  of  variation. 

AN  ALTERNATING-CURRENT  SOLENOID. 

Wherever  facilities  exist  for  obtaining  an  alternating 
electric-light  current  this  apparatus  can  be  used.  (The 
direct  commercial  current  can  not  be  used  unless  changed 
by  a  transformer.) 

The  apparatus  consists  of  an  induction  coil,  made  to  be 
worn  around  the  body.  The  solenoid  produces  effects 
resembling  the  physiological  action  derived  from  a  high 
frequency  auto-induction  solenoid.  A  small  incandescent 
lamp  held  in  the  center  of  the  solenoid  will  glow  without 
contact  with  any  circuit. 

That  electricity  favors  rapid  growth  in  plants  has  been 
known  for  some  time,  but  only  recently  it  has  been  dis- 
covered that  animal  metabolism  may  be  augmented  by 
electricity,  which  is  satisfactorily  demonstrated  by  the  fact 


PRACTICAL  ELECTRO-THERAPEUTICS.  123 

that  guinea  pigs  and  rabbits  placed  in  an  electrical  solenoid 
will  grow  twenty  per  cent,  faster,  and  be  more  robust  than 
animals  of  the  same  litter  not  so  exposed.  The  author  can 
say  from  personal  experience  that  it  has  a  similar  effect  on 
children  of  backward  growth,  both  physically  and  mentally, 
as  the  following  case  will  show: 

A  boy  seventeen  years  old  had  not  increased  any  in  height 
or  weight  since  he  was  eleven  years  old.  During  this  period 
of  six  years  he  had  been  under  the  care  of  able  physicians 
in  various  parts  of  the  country.  The  last  two  years  had 
been  spent  in  the  mountains  under  the  care  of  a  physician 


Alternating  Current  Couch. 

that  laid  great  stress  on  physical  culture,  etc.  This  treat- 
ment hardened  the  boy's  nature,  but  did  not  assist  his 
growth.  The  boy  measured  four  feet  nine  and  five-eighths 
inches  and  weighed  sixty-seven  and  a  quarter  pounds.  An 
X-ray  examination  showed  that  the  ends  of  the  boy's  bones 
were  not  yet  ossified,  hence  there  was  still  hope  for  growth. 
The  boy  was  otherwise  in  perfect  health. 

Under  influence  of  static  electricity,  alternating  solenoid 
and  oil  rubbings  for  one  month,  the  boy  grew  three-quarters 
of  an  inch  in  height  and  gained  three  and  a  half  pounds  in 
weight.  He  was  then  taken  to  California  in  the  hope  that 
the  mild  climate  of  that  country  would  help  him  grow  now 
that  he  had  a  start.  On  returning  at  the  end  of  seven 
months  he  was  found  to  have  gained  about  three-quarters 


124  PRACTICAL   ELECTRO-THERAPEUTICS. 

of  an  inch,  or  about  one-eighth  inch  a  month.  He  was  again 
placed  under  treatment,  and  under  the  use  of  the  solenoid 
alone  (static  electricity  being  omitted)  and  oil  inunctions 
gained  about  one-half  inch  each  month  for  the  next  five 
months. 

In  the  author's  opinion  oil  is  an  important  element  in 
hastening  growth,  as  is  seen  in  children  suffering  from 
rickets.  But  that  oil  alone  will  not  bring  about  such  rapid 
growth  was  demonstrated  by  cases  who  had  received  oil 
rubbings  for  some  time  responding  and  making  more  rapid 
progress  when  the  solenoid  was  used. 

A  couch  may  also  be  used  with  the  alternating  commercial 
current  on  the  same  principle  as  the  solenoid.  That  mag- 
netic waves  surround  the  patient  lying  on  the  couch  is  shown 
by  lighting  a  lamp  held  over  the  couch. 

On  a  person  in  perfect  health  there  is  no  apparent  effect, 
while  a  patient  tired  or  suffering  from  nervousness  may 
become  drowsy  and  gradually  fall  into  a  refreshing  sleep. 
It  stimulates  the  functional  organs  and  the  centers  to  nerv- 
ous and  physiological  activity,  and  thus  hastens  elimination 
and  promotes  healthy  tissue  growth.  As  no  technical  skill 
is  required  to  operate  the  apparatus,  it  can  be  placed  in  the 
patient's  home  and  there  employed  under  the  physician's 
direction. 


ROENTGEN  OR  X-RAYS. 

The  X-rays  emanate  from  a  mode  of  motion  imparted  to 
rarefied  air  in  the  tube,  the  tube  being  exhausted  to  about 
one  two-thousandth  of  an  atmosphere  in  order  to  leave  the 
structures  of  air  more  free  to  move  A  thin  substance  may 
be  stirred  more  readily  than  a  thick  one  with  the  same 
energy,  and  as  the  mode  of  motion  imparted  to  the  structures 


\U\\\V\\\UV\\Vtti 


Rhumpfkorf  Coil. 

of  the  air  must  be  a  very  high  mode  of  motion  in  order  to 
produce  X-rays,  it  is  necessary  that  the  tube  be  properly 
exhausted,  as  a  great  .deal  depends  on  the  vacuum  in  the 
tube. 

So  far  the  only  means  we  have  at  our  service  for  produ- 
cing this  intense  bombardment  and  its  consequent  X-ray  is 
the  electric  current.  The  X-ray  is  not  some  form  of  electri- 
city, but  is  a  higher  rate  of  vibration  even  than  light,  and 
is  the  transformed  energy  of  the  electric  current.  This 
latter  is  simply  the  mechanism  for  its  production.  Any 
other  form  of  energy,  which  would  bombard  the  metal  plate 
with  sufficient  intensity  would  also  produce  the  X-ray,  and 
it  may  be  in  the  future  some  such  other  method  may  be  dis- 
covered. 

125 


126  PRACTICAL   ELECTRO-THERAPEUTICS. 

The  apparatus  used  to  excite  an  X-ray  tube  is  either  a 
static  machine  or  one  of  the  various  modifications  of  induc- 
tion coils.  The  Ruhmkorff  coil  transforms  a  low  pressure 
current  into  one  of  high  potential  by  means  of  an  induction 
coil.  To  excite  an  induction  coil  it  is  necessary  to  bring  two 
entirely  separate  and  distinct 'circuits  near  each  other,  but 
not  in  contact.  A  current  passing  through  one  will,  by 
mutual  induction,  produce  an  electrical  current  in  the  other, 
running  in  an  opposite  direction.  If  a  break  is  made  in  the 
primary  circuit,  a  secondary  current  is  for  the  moment 
induced  in  the  secondary  circuit.  If  this  make  and  break 
is  done  with  great  rapidity,  the  induced  current  will  be  one, 
continuously  changing  its  direction;  in  other  words,  an  alter- 
nating current. 


Diagram  of  Magnetic  Field  of  Induction  Coil. 

The  central  core  of  a  Ruhmkorff  coil  consists  of  a 
cylindrical  bundle  of  thin,  soft  iron  wires  bound  together  and 
thoroughly  insulated  by  being  impregnated  with  paraffine 
wax.  Around  this  core  is  wound  the  primary  circuit,  con- 
sisting of  a  comparatively  short  length  of  stout  silk-covered 
copper  wire,  the  whole  being  insulated  with  paraffine  wax, 
and  when  cool  pushed  into  a  properly  fitting  ebonite  tube  to 
thoroughly  insulate  it  from  the  secondary  circuit.  As  the 
current  is  passed  through  the  primary  circuit  the  iron  core 
becomes  magnetized  and  emits  lines  of  magnetic  influence. 

The  secondary  coil  consists  of  many  turns  of  fine  insulated 
wire  (No.  30),  thirty  to  sixty  miles  in  length,  wound  around 


PRACTICAL   ELECTRO-THERAPEUTICS. 


127 


the  primary  and  thoroughly  saturated  in  paraffine  wax.  The 
secondary  wire  is  coiled  in  sections  to  avoid  the  induction  of 
the  outer  coil  on  itself,  which,  on  account  of  the  high  voltage, 
is  liable  to  take  place,  no  matter  how  thorough  the  insulation. 
The  wires  are  covered  with  silk  and  each  winding  is  separated 
from  the  others  by  a  layer  of  shellac.  The  windings  of  the 


X-Ray  Coil  and  Interjupter. 

secondary  coil  are  continuously  being  impregnated  by  the 
continuous  flow  from  the  iron  core.  The  electromotive  force 
of  the  induced  current  is  thousands  of  times  stronger  than 
the  primary  current,  on  account  of  the  great  number  of 
secondary  windings.  The  strength  of  the  current  is  re- 
duced by  the  increased  voltage,  as  well  as  by  the  constant 
change  of  its  direction. 


128 


PRACTICAL   ELECTRO-THERAPEUTICS. 


X-Ray  Coil  and  High  Frequency  Apparatus. 


PRACTICAL   ELECTRO-THERAPEUTICS.  129 

The  breaking  of  the  primary  circuit  momentarily  produces 
by  self-induction  a  slight  current  in  the  opposite  direction. 

This  self-induced  current  is  absorbed  by  means  of  con- 
densers, consisting  of  several  layers  of  tinfoil,  separated  by 
sheets  of  paraffine  parchment,  the  alternate  sheets  of  the 
tinfoil  being  attached  to  one  another.  This  absorbed  current 
is  discharged  a  moment  later  through  the  primary  coil,  thus 
creating  a  current  in  the  opposite  direction  to  the  initial 
current,  demagnetizing  the  core  and  greatly  adding  to  the 
efficiency  of  the  coil.  A  twelve-inch  coil  without  condensers 
will  barely  spark  two  inches.  High  frequency  currents  may 
be  produced  with  a  six  inch  coil,  but  the  best  results  can  only 
be  obtained  with  one  of  twelve  or  more  inches. 

The  interrupters  for  the  primary  current  in  the  coil 
machines  may  be  divided  into  four  varieties:  The  mechanical, 
the  mechanico-electrolytic,  the  thermo-electrolytic,  the 
electrolytic. 

Light  may  be  reflected,  refracted  and  polarized;  but  not 
so  the  X-ray?,  which  are  the  highest  form  of  vibration  we 
know  of.  The  waves  are  undoubtedly  too  small  to  be 
reflected  by  any  polish  we  are  at  present  able  to  obtain, 
or  to  be  refracted  by  any  mechanism  we  are  at  present  able 
to  construct.  The  X-rays  travel  in  straight  lines  and  can 
not  be  bent  or  diverged  by  a  magnet  or  any  other  known 
means.  They  induce  chemical  action — are  photographic  and 
cause  fluorescence. 

The  apple-green  hemisphere  seen  in  an  excited  X-ray  tube 
is  the  cathode  stream  which  consists  of  molecules  of  gas, 
still  contained  in  the  tube,  and  the  negative  ions  moving  in 
a  free  path  on  account  ot  the  tenuity  of  the  vacuum.  They 
move  in  straight  lines  from  the  surface  from  which  they  are 
given  off,  therefore  the  cathode  is  made  concave,  so  that  the 
rays  may  converge  to  a  point  on  the  target.  After  these 
rays  meet  to  form  a  pencil,  they  do  not  diverge,  but  continue 
in  a  straight  line  until  they  meet  some  resistance.  Therefore 
the  target  should  be  a  little  beyond  the  true  focus  of  the  con- 
cave disc.  The  cathode  stream  may  be  deflected  by  a  magnet 
in  the  same  manner  as  the  electric  arc,  but  the  X-rays  can 
not.  When  the  cathode  rays  bombard  the  target,  there 
occurs  a  transformation  of  energy  and  the  resultant  X-rays 
are  emitted  in  all  directions  from  the  point  of  bombardment. 

As  the  X-ray  is  invisible  it  is  necessary  to  have  some 


130 


PRACTICAL   ELECTRO-THERAPEUTICS. 


PRACTICAL   ELECTRO-THERAPEUTICS.  131 

medium  to  translate  or  transform  it  so  that  its  manifestations 
can  be  perceived  by  the  human  eye.  This  is  done  by  means 
of  the  fluoroscope.  This  Consists  of  a  piece  of  cardboard 
covered  with  a  thin  layer  of  some  fluorescent  substance, 
preferably  platino-cyanide  of  barium.  For  convenience,  this 
is  made  the  base,  fluorescent  side  inward,  of  a  pyramidal 
box,  of  which  the  apex  is  cut  off  and  adjusted  to  the  face 
about  the  eyes,  so  as  to  cut  off  all  external  light,  in  order 
that  the  fluorescent  picture  may  be  more  distinct. 

Why  the  platino-cyanide  of  barium  becomes  fluorescent  we 
do  not  know.  We  recognize  the  fact  that  it  does  so  and 
make  use  of  it  accordingly.  Inasmuch  as  the  X-rays  pass 
through  substances  in  inverse  proportion  to  their  density,  it 
follows  that  the  denser  substances  will  cast  the  deeper  shad- 


Fluoroscope. 

ows,  and  these  lights  and  shadows  make  the  picture  on  the 
fluorescent  screen  and  photographic  plate.  Since  the  X- 
rays  diverge  from  a  small  point  on  the  target,  the  nearer  the 
object  is  to  the  tube,  the  greater  will  be  the  magnification, 
and  vice  versa. 

When  the  current  is  continuous,  the  higher  the  vacuum 
the  greater  the  penetration,  because  as  the  molecules  have  a 
freer  path  they  strike  the  target  with  greater  force,  and 
consequently  the  X-ray  is  more  intense. 

One  thing  not  to  be  overlooked  in  an  X-ray  tube  is  the 
degree  of  resistance  which  the  glass  forming  the  bulb  of  the 
tube  offers  to  the  X-ray.  As  the  ray  emanates  from  inside 
the  tube  it  must  pass  through  the  glass  forming  the  bulb  of 
the  tube  before  it  can  have  any  effect  therapeutically  or 


132  PRACTICAL  ELECTRO-THERAPEUTICS. 

otherwise.  Consequently,  a  tube  that  has  the  proper  degree 
of  vacuum  and  excited  with  proper  electrical  energy  might 
be  nil,  so  far  as  any  therapeutical  effects  are  concerned,  if  a 
glass  of  high  resistance  to  the  ray  be  used  for  the  bulb.  A 
bulb  made  of  leaded  glass  would  be  equivalent  to  the  use  of 
a  thin  sheet  of  metal  or  screen  between  the  tissue  treated 
and  a  good  tube. 

To  test  a  tube  in  this  respect,  examine  it  with  the  X-ray 
in  the  same  manner  as  you  would  your  hand,  and  you  will 
find  that  a  poor  glass  tube  casts  a  denser  shadow  upon  a 
fiuoroscope  than  a  good  tube.  A  tube  blown  very  thin,  and 
of  the  proper  quality  of  glass,  greatly  increases  the  penetrat- 
ing power  as  well  as  the  efficiency  of  the  tube.  The  difference 
is  readily  distinguished  if  the  tube  be  examined  with  the  X- 
ray.  No  one  would  think  of  making  X-ray  exposure  through 
a  thickness  of  metal  and  expect  good  therapeutical  results. 

All  X-ray  operators  employ  the  same  general  technique. 
The  static  and  coil  machines  seem  to  be  on  an  equal  footing 
as  far  as  the  results  are  concerned.  The  same  ma}'  be  said 
of  the  great  variety  of  tubes  now  in  use,  but  one  can  never  be 
certain  of  securing  good  tubes  until  he  has  given  them  a  trial. 

The  X-ray  operator  should  have  several  tubes  and  should 
learn  their  capacity  and  their  moods.  In  general,  the  size  of 
the  tube  should  correspond  with  the  capacity  of  his  machine. 
There  are  advantages  in  having  tubes  of  different  patterns, 
according  to  the  purposes  for  which  they  are  used.  Those 
that  have  a  specially  good  focus  (the  target  reddening  at  or 
near  its  center)  should  be  reserved  for  skiagraphy,  for  radio- 
therapy does  not  require  good  definition. 

Most  new  tubes  possess  a  low  vacuum  and  gradually 
become  hardened  through  use  and  lose  their  usefulness  for 
therapeutic  purposes.  By  heating  the  tube  equally  a  few 
minutes  over  a  spirit  lamp,  the  vacuum  is  quickly  lowered 
and  the  tube  rendered  soft.  After  a  tube  has  been  treated 
in  this  manner,  it  requires  but  little  use  to  reduce  it  to  the 
same  degree  of  hardness  which  it  previously  possessed. 
Eventually  the  tube  becomes  so  hard  that  it  is  impossible 
to  reduce  it  to  the  proper  degree  of  softness. 

Old  tubes  that  have  a  tendency  to  become  too  low  or  too 
high  while  being  used  may  very  often  be  made  to  serve  well 
by  the  employment  of  a  single  or  multiple  spark-gap,  or  if 
they  are  persistently  too  high  they  may  be  baked  in  an  oven. 


PRACTICAL   ELECTRO-THERAPEUTICS.  133 

When  the  shadows  of  the  forearm  or  hand  on  the  fluorescent 
screen  are  so  black  that  the  bone  shows  scarcely  or  not  at 
all,  the  vacuum  is  too  low  for  fluoroscopy  (Fig.  a),  though 


Fig.  a. 


a  skiagram  may  be  made  with  a  very  long  exposure.  When 
the  bones  of  the  hand  or  forearm  appear  very  black  on  the 
screen,  the  vacuum  is  low  (Fig.  b),  and  when  these  appear 


Fig.  b. 


very  light,  their  outlines  distinct,  the  vacuum  is  very  high 
(Fig.  c). 

When  the  sparks  pass  around  the  tube  from  pole  to  pole, 
the  vacuum  is  too  high  and  the  tube  is  in  danger  of  being 
punctured  (Fig.  i). 


134 


PRACTICAL   ELECTRO-THERAPEUTICS. 


When  the  fluorescence  in  the  tube  is  a  rich  green  and  is 
easily  seen  in  a  well-lighted  room,  the  vacuum  is  usually  low 
(Fig.  3),  and  when  the  fluorescence  is  less  bright  and  its 
coloring  yellowish  green,  the  vacuum  of  the  tube  is  high  and 
has  great  penetrating  power.  Pictures  of  the  hand  lack 


Fig.  c. 


contrast,  the  soft  parts  of  the  bones  being  easily  penetrated 
(Fig.  2). 

The  color  and  brilliancy  of  tube  fluorescence  depend  in  part 
upon  the  volume  of  current  employed,  but  also  upon  the  age 
of  the  tube. 


Fig.  1. 

Tubes  that  have  been  much  used  lose  the  brightness  of  their 
fluorescence  and  in  them  the  vacuum  may  still  be  low  when 
the  coloring  is  yellowish  green  (Fig.  4). 

When  the  target  of  the  tube  quickly  heats  with  a  moderate 
current,  the  vacuum  is  low,  but  if  without  a  water-cooling 
attachment  the  target  remains  cold  with  a  considerable  volume 
of  current  passing  through  the  tube,  the  vacuum  is  high. 


PRACTICAL   ELECTRO-THERAPEUTICS.  135 

If  there  is  a  blue  light  in  the  upper  part  of  the  tube  above 
the  target,  the  vacuum  is  low,  and  the  greater  the  amount 
of  this  blue  light,  the  lower  the  vacuum  (Fig.  5). 

If  the  blue  light  passes  between  the  cathode  and  the  target, 
the  vacuum  is  very  low,  and  the  tube  must  be  cautiously 
regulated  or  it  will  be  ruined. 


If  the  blue  light  is  replaced  by  a  violet  light,  the  tube  should 
be  set  aside  for  several  days  to  rest. 

If  the  violet  light  passes  between  the  cathode  and  the 
target, the  tube  is  probably  punctured. 

If  sparks"  arc  across  between  the  poles,  the  tube  has  been 
punctured.  In  very  old  tubes  this  violet  light  may  pass 
between  the  cathode  and  antecathode  without  the  immediate 


usefulness  of  the  tubes  being  necessarily  impaired,  though 
they  have  passed  the  stage  where  they  may  be  considered 
good. 

When  the  spark  jumps  between  the  lead  wires,  the  vacuum 
is  too  high  or  the  wires  are  too  near  together. 

By  the  above-mentioned  signs  the  operator,  as  a  rule,  can 
determine  the  tension  of  his  tube  while  it  is  in  operation  with- 
out exposing  his  hand  before  a  screen.  In  therapeutic  work 
the  practice  is  fairly  general  to  use  low  vacuum  for  surface 
lesions  and  high  vacuum  for  more  deeply  seated  diseases. 


136  '  PRACTICAL   ELECTRO-THERAPEUTICS. 

The  value  of  X-rays  is  no  longer  limited  to  the  elementary 
study  of  the  skeleton  lesion,  nor  their  use  confined  to  a  feu- 
experts,  but  are  passing  into  the  hands  of  the  profession  at 
large,  where,  with  other  instruments  of  precision,  they 
properly  belong. 

To  interpret  the  findings  of  an  X-ray  examination  experi- 
ence is  needed,  but  this  is  true  of  the  stethoscope,  the 


ophthalmoscope,  cystoscope  and  other  instruments  for 
examining  the  interior  of  the  body. 

One  practiced  in  fluoroscopy  can,  with  moderate  illumina- 
tion, discern  on  the  screen  details  which  another,  whose  eyes 
are  not  trained,  can  not  see  at  all,  even  with  bright  light. 

Fluoroscopy  has  its  marked  limitations.  Many  details 
may  be  found  upon  a  plate  which  the  screen  entirely  fails  to 
show,  and  even  fractures  may  be  overlooked  if  one  limits 
his  investigation  to  fluoroscopy. 


Fig.  5. 

In  making  a  skiagram  for  locating  foreign  bodies,  as  well 
as  fractures,  it  is  well  to  make  two  or  more  pictures.  (It 
must  be  remembered  that  the  picture  on  the  screen  is  a 
shadow  of  the  part  examined  and  that  there  are  many  sources 
from  which  errors  may  arrive.)  This  will  enable  one  to 
locate  the  trouble  exactly.  It  is  even  desirable  that  the 
operator  develop  his  own  plates. 

The  tube  which  allows  the  operator  to  see  the  shadow  of 
his  hand  on  a  screen  at  a  distance  of  fifteen  to  thirty  feet 
can  not  be  depended  upon  to  make  a  good  picture  at  a  dis- 
tance of  two  feet.  When  the  vacuum  is  such  as  to  give  a 


PRACTICAL   ELECTRO-THERAPEUTICS. 


137 


satisfactory  picture  on  the  screen,  it  is  higher  than  it  ought 
to  be  for  the  best  results  with  plate  exposure  of  the  same 
parts.  In  making  a  skiagram  the  length  of  exposure  rather 


than  the  vacuum  should  be  varied  to  allow  for  differences 
in  density. 

In  skiagraphical  work,  it  is  desirable  to  have  a  tube  with 
sharpness    of    definition    or    focusing   powers.      To  make  a 


CATHODE         \-    *~*f/  ANOOE 

Pole  Changer  and  Tube  Regulator. 

test  hold  the  fluoroscope  about  two  feet  from  the  tube  and 
hold  a  twenty  mesh  wire  sieve  between  them.  The  nearer 
it  is  necessary  to  bring  the  screen  to  the  fluoroscope,  the 
poorer  the  focus,  and  the  farther  away,  the  more  accurate  the 
focus.  A  tube  now  on  the  market  has  the  anode  mounted 


138 


PRACTICAL  ELECTRO-THERAPEUTICS. 


on  a  threaded  stem  which  can  be  magnetically  operated 
through  the  glass,  moving  it  up  or  down  or  circumferentially 
with  the  surface  of  the  tube  to  obtain  an  accurate  focus. 


Examining  Focus  of  Tube. 

The  most  satisfactory  tubes  for  use  are  those  constructed 
in  such  a  way  as  to  permit  regulation  of  the  vacuum  in  the 
tube. 


New  Safety  X-Ray  Tube. 

These  tubes  contain  two  regulators,  one  giving  off  a  gas 
under  the  influence  of  the  negative  wire,  thus  lowering  the 
vacuum;  the  other,  being  composed  of  an  irido-platinum  spire 


PRACTICAL   ELECTRO-THERAPEUTICS. 


139 


wire,  absorbs  the  free  corpuscles  in  the  tube,  gradually  rais- 
ing the  vacuum  to  the  desired  point. 

In  the  field  of  internal  medicine  the  X-rays  are  a  valuable 
aid  to  our  methods  of  examination.  This  is  especially  true 
in  abscess  of  the  lung,  pleurisy  with  effusion,  pneumo-thorax, 


Celluloid  X-Ray  Specula. 

pneumo-pyo-thorax,  subphrenic  abscess,  pericardial  effu- 
sions, hypertrophies  and  dilatation  of  the  heart,  displacement 
of  the  heart,  calcareous  deposits  at  the  valves,  atheromatous 
patches  in  the  aorta  and  thoracic  aneurism,  whose  presence 
could  not  be -demonstrated  by  means  of  percussion  or 
auscultation. 


Pole  Changer. 

In  making  examinations  of  the  chest  for  diagnosis  of 
tuberculosis  in  its  early  stages,  we  must  constantly  bear  in 
mind  the  normal  conditions  for  comparison.  We  have  to 
discriminate  shadows  of  the  chest,  neck,  shoulder,  clavicle 
and  ribs,  and  not  consider  the  circumscribed  shadows  as  due 
to  pulmonary  atelectasis.  The  rays  frequently  show  the 
disease  to  be  more  extensive  than  has  been  mapped  out  by 
the  usual  methods  of  examination. 


140  PRACTICAL   ELECTRO-THERAPEUTICS. 

After  many  repeated  observations,  loss  of  mobility  of  the 
diaphragm  seems  to  be  the  earliest  indication  of  tubercular 
mischief  in  the  lungs. 

In  children  a  simple  bronchitis  may  be  differentiated  from  a 
bronchial  pneumonia  or  a  croupous  pneumonia,  and  enlarged 
bronchial  glands  may  be  frequently  noticed. 

The  X-rays  are  also  a  valuable  aid  in  locating  foreign 
bodies  in  the  lungs.  These,  unless  removed,  may  cause  a 
septic  pneumonia  or  septicemia. 

Following  the  exhibition  of  bismuth,  the  patient's  stomach 
may  be  outlined  and  the  peristaltic  action  of  the  intestines 
may  be  studied. 

In  orthopedic  work  the  X-rays  are  based  upon  a  positive 
and  scientific  basis,  and  have  become  a  necessity,  because  so 
much  of  its  sphere  has  to  do  with  diseases  of  the  bones  and 
this  is  what  the  X-rays  are  most  prominently  used  for.  In 
a  swollen  or  extremely  painful  ioint  or  limb  the  X-rays  permit 
us  to  seethe  condition  of  the  bones  and  thus  prevent  tubercu- 
lar joints,  etc.,  from  being  classed  as  rheumatism.  This  will 
prevent  many  stiff  joints.  A  skiagraph  will  show  the 
difference  between  osteoarthritis  with  enlargement  of  the 
bones  from  rheumatoid  arthritis,  where  the  disease  is  due  to 
the  cartilaginous  portion,  and  where  the  bone  frequently 
diminishes  in  size  as  the  disease  advances. 

An  interesting  case  occurred  in  the  author's  experience. 
A  boy  seventeen  years  old  who  had  failed  to  grow  even  a 
fraction  of  an  inch  in  height  since  he  was  eleven  years  old 
had,  on  physical  examination  been  declared  by  eminent 
authority  to  have  reached  his  full  height  and  that  further 
efforts  in  that  direction  would  be  without  avail.  The  boy 
was  examined  by  means  of  the  fluoroscope,  which  showed 
the  epiphyseal  and  diaphyseal  cartilages  had  not  yet  become 
ossified.  Under  electrical  treatment  and  massage  the  boy 
gained  one-half  inch  a  month  while  under  treatment,  but 
would  cease  growing  when  treatment  was  discontinued.  In 
two  years  the  boy  grew  seven  inches. 

The  X-rays  may  be  extremely  valuable  in  helping  us  to  clear 
up  the  diagnosis  of  obscure  nervous  diseases,  as  a  callous 
formation  might  simulate  a  number  of  pathological  condi- 
tions. 

One  of  the  greatest  diagnostic  achievements  and  the  most 
exacting  work  of  the  X-rays  is  the  search  for  renal,  urethral 


PRACTICAL   ELECTRO-THERAPEUTICS. 


141 


and  vesical  calculi  in  the  living  body,  making  an  exploratory 
operation  unnecessary.  Gall-stones  may  also  be  photographed 
when  of  phosphatic  formation. 

The  compression  method  as  first  adopted  in  Germany  is  a 
device  by  which  pressure  is  exerted  by  a  directing  tube 
through  which  the  rays  are  aimed  at  an  exact  target.  This 
not  only  enables  you  to  reduce  the  thickness  by  compressing 
the  soft  parts,  but  also  enables  one  to  push  aside  the  obstruct- 
ing part,  enabling  the  rays  to  better  reach  the  kidneys  and 
bringing  the  objects  sought  nearer  the  photographic  plate. 
It  also  serves  to  fix  the  parts  on  the  table.  This  apparatus 


Compression  Apparatus  in  Use. 

has  the  advantage  of  permitting  us  to  use  small  plates,  which 
are  comparatively  inexpensive.  A  high  degree  of  sharpness 
also  is  obtained,  as  voluntary  and  involuntary  movements  are 
out  of  the  question.  The  tube  is  always  the  same  distance 
from  the  body. 

The  principal  advantage  of  the  compression  tube  is  that  it 
permits  radiographs  of  the  head,  shoulder,  hip-joint,  lumbar 
vertebra,  etc.,  to  be  taken,  which  compare  favorably  with 
dissected  bones. 

This  apparatus  with  the  use  of  a  penetrometer  which  has 
been  standardized  by  the  German  government,  enables  the 
operator  to  duplicate  results  almost  exactly,  as  he  can 
accurately  determine  the  penetrating  power  of  his  tube. 


142  PRACTICAL  ELECTRO-THERAPEUTICS. 

The  penetrometer  consists  of  a  small  fluoroscopic  screen 
arranged  in  an  oval-shaped  box  with  six  circular  platinum 
disks,  set  in  a  lead  plate.  Each  of  these  platinum  disks  is  of 
a  different  density,  hence  determines  the  penetrating  qualities 
of  the  rays. 

Since  the  introduction  of  the  X-ray  and  its  wonderful 
power  to  penetrate  opaque  substances,  its  efficacy  has  been 
demonstrated  in  the  treatment  of  certain  affections  which 
have  hitherto  eluded  both  the  physician  and  the  surgeon. 

The  list  of  diseases  in  which  the  rays  have  been  used  with 
varying  success  at  the  present  time  includes  epithelioma, 
carcinoma,  sarcoma,  psoriasis,  eczema,  hypertrichosis, 
sycosis,  naevus,  lichen  planus,  pruritis,  dermatitis  of  an 
itching  nature,  keratosis,  acne  and  keloid,  leukemia,  pseudo- 
leukemia,  pain  in  malignant  growths  and  tubercular  joints, 
superficial  parasitic  diseases  and  neuralgias,  and  rheumatism 
of  a  subacute  nature  in  the  joints.  The  X-ray  is  one  of  the 
most  certain,  definite  and  effective  remedies  for  the  relief  of 
pain,  and  the  anodyne  effects  of  the  raying  are  not  produced 
by  local  anesthesia,  but  change  the  disordered  sensations 
into  orderly  and  normal  ones. 

One  operator  has  found  that  deeply  penetrating  rays  have 
arrested  the  progress  of  degenerative  changes  in  tabetic 
patients,  possibly  causing  an  obliteration  of  the  cells  of  low 
vitality  and  stimulating  a  more  healthy  action  and  increased 
resistance  in  the  normal  tissues.  At  any  rate,  he  succeeded 
in  arresting  the  lightning  pain,  reducing  the  ataxic  symp- 
toms, causing  a  return  of  the  knee  jerk  and  an  improvement 
in  the  general  condition. 

No  one  should  undertake  the  use  of  this  agent  who  is  not 
reasonably  familiar  with  its  physical,  physiological  and 
therapeutic  properties.  In  the  hands  of  a  safe  and  reliable 
operator  it  is  capable  of  great  good,  while  in  the  hands  of 
one  ignorant  of  its  properties  it  may  do  much  harm. 

The  technique  of  X-ray  therapy  is  not  a  science;  it  is  an 
art,  and  can  not  be  learned  from  books.  It  is  the  product  of 
experience,  and  experience  only  teaches  us  the  demands  and 
particular  needs  of  each  individual  case. 

Making  exposures  for  therapeutic  purposes  requires  fine 
and  careful  discrimination,  and  should  be  dispensed  very 
much  the  same  as  any  other  drug. 

The  X-ray  exposure  at  first  must  be  tentative,  to  discover 


PRACTICAL   ELECTRO-THERAPEUTICS.  143 

any  so-called  idiosyncrasy  of  the  patient.  There  is  no  doubt 
that  with  the  same  apparatus,  same  tubes  and  same  length 
of  time  of  exposure  no  two  persons  will  respond  exactly 
alike.  What  will  have  a  stimulating  effect  on  healthy  tissue 
may  cause  a  slight  reaction  in  diseased  tissue.  It  is  not  the 
X-ray  so  much  as  the  judgment  in  administering  it  that 
cures. 

The  vacuum  of  the  tube  is  of  prime  importance.  Tubes 
may  be  classified  as  low,  medium  and  high.  A  low  tube  is 
one  that  will  carry  the  current  of  the  generator  without 
backing  up  a  spark,  when  the  prime  conducting  rods  of  the 
machine  are  from  one  to  two  inches  apart;  such  a  tube  as 
this  is  used  in  the  treatment  of  skin  lesions,  such  as  acne, 
eczema,  sycosis,  hypertrichosis,  favus,  etc. 

The  medium  tube  is  one  that  will  carry  the  current  when 
the  poles  of  prime  conductor  are  between  two  and  four 
inches  apart.  It  is  used  in  the  treatment  of  glands,  cancers 
near  the  surface,  etc.  Most  work  in  radiography  and 
fluoroscopy  can  be  done  with  this  tube. 

A  high  tube  is  one  that  will  carry  a  current  without  back- 
ing up  spark  when  the  distance  between  the  poles  of  the 
prime  conductor  is  over  four  inches.  The  tube  is  used  in 
the  treatment  of  deep  lesions,  as  in  affections  of  the  pelvic 
organs,  tuberculosis  of  the  lungs,  osteosarcomata,  etc.  The 
X-ray  only  acts  when  absorbed  by  the  tissues.  The  intensity 
of  action  is  in  proportion  to  the  quantity  of  rays  absorbed 
during  application,  and  this  depends  upon  the  amount  of 
rays  given  off  by  a  given  tube  and  the  duration  of  the 
exposure,  as  well  as  the  distance  separating  the  tissues  from 
the  anticathode.  The  quantity  of  light  received  obliquely 
diminishes  in  proportion  to  the  angle  of  its  inclination  upon 
the  surface  which  it  meets,  consequently  move  the  tube 
about  and  give  all  parts  the  same  exposure;  otherwise  an 
ulcerative  radio-dermatitis  may  occur  in  the  center  and  only 
a  slight  reactionary  symptom  occur  on  the  periphery. 

The  low  tube  should  be  placed  about  three  to  four  inches 
from  the  surface  to  be  exposed,  while  where  the  large  areas 
are  to  be  treated  time  is  gained  by  treating  small  area  at  a 
time. 

With  the  medium  tube  a  distance  of  four  or  five  inches  is 
ample;  with  the  high  tube,  a  distance  of  five  to  six  inches  is 
usually  about  right,  though  the  higher  the  vacuum  of  the 


144  PRACTICAL   ELECTROTHERAPEUTICS. 

tube  the  farther  away  from  the  parts  treated  must  it  be 
placed.  The  farther  the  tube  is  removed  from'  the  body, 
the  less  the  difference  in  the  quantity  of  rays  absorbed  In- 
different areas. 

The  high  tube  is  used  for  the  treatment  ot  internal 
troubles,  as  prolonged  exposure  may  be  made  without 
danger  of  causing  superficial  sloughing  of  tissue. 

Great  care  must,  however,  be  taken  not  to  expose  the 
brain  to  the  high  tube,  as  serious  results  may  follow. 

The  time  of  each  exposure  depends  upon  the  generator. 
In  using  a  sixteen-plate  glass  machine  exposures  of  ten  to 
twenty  minutes  are  as  a  rule  deemed  sufficient,  while  it  a 
twelve-inch  spark  coil  is  used,  eight  to  ten  minutes  will 
suffice.  Allowing  the  energy  to  concentrate  on  the  parts  a 
little  at  a  time  at  frequent  intervals  permits  nature  to  use 
it,  while  too  long  and  vigorous  treatment  at  one  time  mas 
do  much  harm.  Many  operators  begin  with  daily  treatments 
until  a  dermatitis  appears,  which  is  usually  in  two  or  three 
weeks.  In  some  cases  tanning  will  produce  the  desired 
therapeutic  effect,  while  in  others,  nothing  short  of  a  derma- 
titis will  bring  about  success. 

After  a  dermatitis  appears  treatment -is  suspended  entirely 
until  the  parts  have  recovered,  then  the  treatments  are  again 
resumed,  exposure  being  made  every  other  day. 

In  the  treatment  of  pelvic  troubles  the  author  believes 
better  results  are  accomplished  by  treating  the  parts  directly 
either  through  abdomen  or  perineum  than  by  the  speculum 
method  through  the  vagina  or  rectum,  as  by  this  means  only 
a  small  field  is  exposed;  and  the  contiguous  glands  which  are 
always  involved  do  not  receive  the  needed  stimulating  effect 
of  the  X-rays. 

The  X-rays  have  a  decided  inhibitory  influence  on  the 
majority  of  diseases.  In  carcinoma  of  the  intestines,  where 
life  has  been  threatened  with  intestinal  obstruction,  the  symp- 
toms have  been  relieved,  tumor  reduced  inside  and  life 
prolonged  for  variable  periods.  On  the  other  hand,  pain 
and  suffering  have  been  alleviated  in  the  majority  of  cases. 
Rapidly  progressing  malignant  and  inoperable  tumors  have 
been  indefinitely  held  in  check  and  those  that  have  recurred 
after  complete  disappearance  have  in  some  instances  again 
responded  to  further  treatment. 

Under  the  action  of  the  X-rays  the  hair  follicles  and  glands 


PRACTICAL   ELECTRO-THERAPEUTICS.  145 

become  functionally  inactive  and  at  the  same  time  are 
impaired  by  the  cutting  off  of  the  nutrition  furnished  by  the 
normal  blood  supply.  Characteristic  contractions  of  proto- 
plasmic structures  are  produced.  The  arterials  contracting 
deprive  the  skin  of  the  usual  blood  supply. 

Protect  the  parts  of  face  and  head  not  being  treated,  by 
means  of  lead  foil.  Always  apply  the  protective  to  the 
patient  in  preference  to  the  tube,  as  any  motion  of  the 
patient  will  remove  the  part  we  wish  to  treat- and  another 
part  will  receive  the  exposure.  In  treating  the  face  also 
protect  the  projecting  shoulder  if  it  is  nearer  the  tube,  as  it 
might  be  burned  weeks  before  the  part  actually  under  treat- 
ment shows  a  dermatitis.  The  operator  must  be  particu- 
larly careful  to  protect  any  abraded  tissues  he  may  have 
about  his  hands,  as  they  form  a  fruitful  culture  field  for  the 
infections  with  chronic  malignant  diseases. 

If,  for  any  reason,  a  diabetic  patient  is  exposed  to 
X-ray  treatment,  it  must  be  remembered  that  the  reaction 
of  the  X-rays  is  out  of  proportion  to  what  takes  place  in 
other  patients,  on  account  of  the  weakened  condition  of  the 
tissues,  and  gangrene  is  very  apt  to  supervene. 

A  large  number  of  theories  are  advanced  as  to  how  the 
X-rays  exert  their  curative  properties,  but  it  yet  remains 
for  the  investigators  to  reveal  the  facts,  and  when  once 
decided  what  X-ray  does  to  living  tissue,  there  still  remains 
to  decide  how  this  affects  the  cancerous  growth,  and  this 
latter  decision  can  never  be  reached  until  we  know  what 
cancer  is.  The  theory  accepted  by  many  operators  is  that 
its  action  is  largely  that  of  a  mechanical  irritant.  The 
X-rays  have  no  antiseptic  action,  except  in  so  far  that 
the  irritation  produced  by  the  rays  brings  more  blood  to  the 
parts.  The  mild  leucocytous  thus  established  enables  the 
living  tissue  to  cope  with  and  conquer  pathological  cell  pro- 
liferation. Examination  of  tissues  removed  after  having 
been  subjected  to  the  action  of  the  Roentgen  rays  demon- 
strates that  the  alteration  produced  corresponds  to  certain 
areas  whose  nutrient  vessels  had  undergone  changes.  The 
lining  membrane  of  the  blood-vessels  is  primarily  acted  upon. 

When  an  increased  number  of  leucocytes  is  found  in  those 

cases    undergoing    X-ray   treatments,    an    improvement    is 

usually  noticed,  whereas  when   they  become  less  in  number 

than  when  the  treatment  was  begun,  then  a  continuation  is 

10 


146  PRACTICAL    ELECTRO-THERAPEUTICS. 

useless.  A  combination  of  X-ray  treatments  and  internal 
medication  gives  the  best  results,  the  internal  treatment  con- 
sisting in  securing  the  proper  degree  of  alkalinity  in  the 
system,  the  administration  of  either  arsenic  or  thyroid  ex- 
tract, or  both. 

An  increase  in  the  amount  of  nitrogen  products  eliminated 
is  detected  shortly  after  raying  and  for  a  few  days  follow- 
ing, and  may  account  for  the  fatal  ending  following  the 
use  of  X-rays.  Lassitude,  complete  anorexia,  cephalal- 
gia,  palpilation  vertigo  and  insomnia  are  symptoms  which  fre- 
quently follow  the  disintegration  of  neoplasms,  and  are  due  to 
the  absorption  of  the  debris;  open  ulcers  with  abundant 
secretion  are  less  apt  to  show  toxic  symptoms  when  treated. 
OP  account  of  the  retrograde  action  of  the  growth  and  the 
consequent  toxemia,  eliminative  treatment  should  be  insti- 
tuted as  soon  as  the  X-ray  treatment  has  begun. 

The  liver,  the  kidney,  the  skin,  and  such  'organs  as  are 
intimately  concerned  in  the  elimination  of  poisons,  should  be 
stimulated  to  activity.  The  use  of  calcium  sulphide  and 
iodide  of  potass  seems  to  be  a  great  favorite  with  many  X-ray 
operators. 

In  the  treatment  of  Hodgkin's  disease  and  other  ailments 
where  it  is  necessary  to  X-ray  the  entire  body,  the  patient 
may  be  exposed  to  tfie  rays  at  the  proper  distance  and  inten- 
sity daily  from  three  quarters  of  an  hour  to  an  hour  without 
suffering  harm;  on  the  contrary,  gaining  in  health  all  the  time. 

Examination  of  lymph  glands  after  prolonged  treatment 
shows  them  to  be  greatly  sclerosed;  this  undoubtedly  explains 
the  reason  why  cases  of  exopthalmia  goiter  are  favorably 
affected  by  this  form  of  treatment.  It  reduces  glandular 
activity,  and  reduces  absorption  by  the  effects  it  has  upon 
the  lymphatics;  as  these  conditions  take  place  we  find  marked 
improvement  results  in  the  various  symptoms:  nervousness, 
exopthalmos  and  tachycardia  steadily  decrease. 

The  X-rays  are  apparently  a  valuable  aid  in  the  treatment 
of  pulmonary  tuberculosis,  though  by  no  means  a  curative 
measure.  Hemorrhagic  cases  have  made  surprisingly  quick 
recoveries,  wonderful  improvement  taking  place  in  eight  to 
twelve  weeks.  Fibroid  cases  are  very  slow  healing  and  it 
is  doubtful  if  X-ray  exposures  have  any  effect.  The  tem- 
perature is  frequently  relieved,  but  beyond  this  there  is  no 
notable  change. 


PRACTICAL    ELECTRO-THERAPEUTICS.  147 

Sarcomas  yield  more  readily  to  treatment  than  carcinomas, 
yet  sarcomas  of  the  bone  are  not  very  hopefully  affected  by 
the  X-rays. 

Carcinomas  of  vascular  regions  as  the  anus  or  rectum  are 
very  obstinate  in  their  behavior  to  the  X-rays. 

In  carcinoma  of  the  mammae  the  X-ray  has  proven  itself 
very  serviceable  and  in  operative  cases  the  results  now  are 
far  more  favorable  than  formerly,  if  the  X-rays  are  used 
before  and  after  the  operation. 

In  the  treatment  of  cancers,  it  may  be  put  forward  as  a 
broad  general  statement  that  the  earlier  the  disease  is  dis- 
covered and  X-radiation  employed,  the  more  confident  we 
may  be  of  success,  for  two  reasons: 

First,  because  the  new  growth  is  cut  down  and  restricted 
more  easily  than  when  more  matured. 

Second,  because  the  cancerous  particles  have  not  had  time 
to  migrate  from  their  initial  foci  and  spread  the  disease 
widely  in  districts  which  may  be  inaccessible.  Every  case 
of  cancer  should  be  treated  with  the  X-ray  at  once,  before 
surgical  operation,  and  every  case  operated  upon  should  be 
treated  as  soon  as  possible  to  prevent  a  return  of  the  disease. 

The  universally  disastrous  results  or  sequences  of  operative 
procedure  are  due  to  the  failure  of  reaching  all  the  infected 
area.  If  the  tumor  is  well  advanced,  X-radiation  may 
produce  retrogression  of  the  growth,  but  even  though  this  is 
so,  there  still  remains  a  vast  mass  of  diseased  tissue,  which 
it  is  desirable  to  get  rid  of  and  which  should  be  removed  by 
the  knife. 

The  cancer  cells  that  infiltrate  the  organ,  being  of  lower 
vitality  than  the  cells  of  the  surrounding  normal  tissue, 
break  down  and  are  absorbed  into  the  circulation  and  are 
thus  eliminated.  The  same  fate  awaits  the  cells  which  infil- 
trate the  glands.  If  exposures  are  carried  too  far,  not  only 
cancer  cells  but  all  tissue  rayed  will  suffer  a  like  fate. 
Having  arrested  the  growth  of  the  tumor  the  surgeon  is 
called  on  to  remove  the  offending  material.  This  saves  the 
patient  much  suffering,  if  not  danger  of  toxemia  which 
might  happen  if  removed  by  absorption  alone. 

To  avoid  an  overexposure  one  had  best  proceed  in  a 
methodical  manner,  keeping  a  memorandum  of  both  the  dis- 
tance of  the  tube  from  the  part  exposed  and  the  time  of  the 
exposure.  One  may  begin  with  a  distance  of  ten  inches  for 


148  PRACTICAL    ELECTRO-THERAPEUTICS. 

a  ten  minutes'  exposure,  diminishing  one  inch  for  each  treat- 
ment until  the  distance  is  five  inches  from  the  exposed  area. 
The  time  may  be  gradually  increased.  The  object  is  to 
create  a  mild  dermatitis,  taking  care  not  to  induce  such  an 
irritation  as  would  result  in  the  destruction  of  the  skin  or 
subcutaneous  tissue. 

This  dermatitis  is  not  unlike  the  tanning  of  the  skin  when 
exposed  to  the  rays  of  the  sun.  Several  treatments  may  be 
given  before  this  bronzing  or  tanning  effect  is  appreciated. 
As  a  rule  no  therapeutic  effects  are  noticed  until  it  is  estab- 
lished. The  number  and  lengths  of  treatment  it  has  taken 
to  produce  this  dermatitis  will  be  an  excellent  criterion  of 
the  patient's  susceptibility.  The  operator  will  get  the  best 
results  by  regulating  the  length  and  frequency  of  exposure 
so  that  the  bronzing  may  continue  and  become  more  pro- 
nounced without  producing  an  actual  burn. 

Desquamation  usually  follows  this  dermatitis,  and  the 
patient  has  a  slight  burning  after  the  treatment,  which 
usually  wears  off  in  twenty-four  hours.  Should  the  expo- 
sure be  too  frequent  and  long,  an  actual  and  aggravated 
burn  will  occur,  penetrating  the  tissues  beneath  the  skin, 
and  in  some  instances  be  followed  by  large  sloughs. 

Overzealous  radio-therapy  is  to  be  avoided  and  condemned. 
The  operator  should  never  neglect  to  inquire  of  the  patient 
about  sensations  experienced  in  the  region  being  X-rayed. 
The  first  sensation  of  an  impending  X-ray  burn  is  a  sense 
of  tightness  in  t  lie  region  irradiated.  Following  this  symptom 
and  frequently  coincident  with  it,  there  may  be  an  itching 
of  the  part,  redness  and  a  sense  of  heat.  In  the  presence 
of  such  symptoms  no  further  exposure  should  be  made  until 
symptoms  subside.  This  may  take  a  few  days  or  a  few 
weeks.  When  treatment  is  begun,  the  first  treatment  should 
be  short,  two  minutes  with  a  coil  and  ten  with  a  static 
machine  every  other  day  for  a  few  months.  Then  an  inter- 
val of  four  or  five  days  is  given  to  see  if  there  is  a  tendency 
to  a  dermatitis.  If  not,  another  is  made,  still  a  short  one, 
and  three  to  four  days  allowed  to  pass.  If  at  the  end  of  this 
time  no  symptoms  manifest  themselves  prolonged  exposure 
can  be  made.  k 

It  seems  that  individuals  who  are  sensitive  to  the  sun's 
rays  are  likewise  sensitive  to  the  X-rays.  Idiosyncrasy, 
here  as  elsewhere,  plays  its  part. 


PRACTICAL    ELECTRO-THERAPEUTICS.  149 

It  is  necessary  that  the  operator  take  some  precaution  to 
protect  his  hands  and  body. 

When  treating  an  extensive  affection  of  the  face,  as  acne, 
particular  pains  should  be  taken  to  completely  cover  the 
hair  to  the  margin  as  well  as  the  eyebrows,  thereby  avoid- 
ing accidental  alopecia. 

In  treating  epithelial  growths  of  the  face  protect  the  parts 
not  involved.  It  is  always  wise  to  screen  the  trunk  when 
the  face  is  being  treated,  and  vice  versa. 

As  the  axillary  glands  are  usually  involved  in  cancer 
of  the  breast,  it  is  usually  well  to  give  one  radiation  from 
the  front  and  one  radiation  from  the  side  at  each  treatment. 


Jacket  X-Ray  Tube  for  Treating  Cavities. 

As  it  is  impossible  to  say  how  extensive  a  cancer  infiltra- 
tion has  become,  the  greater  the  area  treated  the  greater  the 
chances  are  of  safety  to  the  patient.  If  only  the  tumor 
itself  is  treated  it  frequently  happens  that  the  lymphatics 
draining  the  diseased  tissue  become  larger,  though  the 
treated  area  becomes  smaller.  The  futility  of  a  shield  in 
such  a  case  is  obvious.  We  want  to  reach  all  the  carcinoma 
cells  if  we  can,  and  the  so-called  shield  does  not  shield  the 
patient,  but  the  carcinoma  cells. 

Of  what  use  to  treat  a  local  sore  and  neglect  the  outlying 
section,  which  in  its  turn  is  certain  to  carry  off  the  patient.  In 
short,  it  is  important  to  cause  the  radiations  to  reach  the 
tumor  and  its  lymphatics  from  as  many  directions  as  possible. 

When  an  open  ulcer  exists,  there  is  a  danger  of  secondary 
infection  in  the  treatment  itself,  for  if  the  Crook's  tube  be 
examined,  especially  if  it  was  one  of  high  vacuum,  it  will  be 
found  coated  with  dust  and  dirt  particles.  These  are  positive 
particles  corresponding  to  a  similar  shower  of  negative 


150  PRACTICAL    ELECTRO-THERAPEUTICS. 

particles,  which  are  projected  into  the  ulcer  and  which  may 
lead  to  the  secondary  infection  alluded  to.  For  this  reason 
it  is  well  to  cover  an  open  ulcer  with  a  layer  of  absorbent 
cotton  during  the  treatment. 

Too  vigorous  an  application  of  the  X-rays,  by  breaking 
down  diseased  tissue  and  throwing  it  upon  the  lymphatic 
circulation  in  large  quantities,  may  cause  an  auto-intoxica- 
tion which,  if  persisted  in,  may  cause  speedy  death.  There 
is  also  the  possible  danger  that  in  the  breaking  down  some 
of  the  living  tumor  cells  may  be  carried  to  remote  parts 
of  the  body,  causing  metastasis. 

We  are  not  justified  to  use  the  destructive  power  of  the 
X-ray  to  cause  necrosis  in  the  manner  of  the  old-fashioned 
cancer  pastes,  etc.  We  must  always  remember  that  cancers 
may  arise  from  X-ray  burns,  and  that  a  number  of  X-ray 
workers  are  at  present  so  afflicted. 

The  so-called  X-ray  burns  do  not  yield  to  treatment  by 
antiseptics;  in  fact  are  always  made  worse  by  the  ordinary 
dressing  as  applied  to  heat  burns  or  surgical  wounds.  After 
sterilizing  the  parts  by  means  of  a  saturated  solution  of 
permanganate  of  potass  the  parts  should  be  protected  by 
sterilized  oil  to  keep  out  the  germ-laden  atmosphere. 

X-ray  burns  may  require  weeks,  months  and  even  years  to 
heal.  An  X-ray  burn  is  not  a  burn  as  applied  to  a  heat 
burn,  which  takes  place  in  a  few  seconds.  It  as  a  rule  takes 
the  X-ray  burn  weeks  and  even  months  to  reach  its  height. 

An  arc  light  (twenty-five  amperes)  projecting  parallel 
rays  from  a  parabolic  mirror  has  demonstrated  its  great 
value  in  preventing  X-ray  dermatitis.  Whereas  it  formerly 
occurred  in  from  three  to  five  weeks,  X-ray  treatment  can 
be  kept  up  indefinitely. 

The  X-rays  diminish  the  resistance  of  the  skin  and  the 
light  from  an  arc  lamp  increases  it,  thus  restoring  the 
resistance  of  the  skin  without  diminishing  the  effects  of  the 
ray  upon  the  parts  beneath. 

Discontinuance  of  the  X-ray  treatment  does  not  always 
mean  a  cessation  of  the  curative  process.  The  effects  of 
radiation  are  frequently  prolonged  for  several  months  after 
the  last  exposure,  showing  that  the  X-rays  have  a  cumulative 
action. 


VIBRATORY  STIMULATION 

The  essential  question  to  the  individual  who  contemplates 
the  treatment  of  disease  by  means  of  vibration,  naturally 
is :  How  are  the  results  sought  to  be  accomplished  ? 

Viewed  from  one  point,  all  disorders  of  whatever  sort 
are  due  to  defective  nutrition.  It  is  the  first  step  in  every 
abnormal  process,  or  indeed  it  may  be  said  without  over- 
statement that  it  constitutes  the  whole  of  it.  The  integrity 
of  an  organ,  as  well  as  the  maintenance  of  its  functions, 
depends  on  a  suitable  supply  of  nutriment,  both  in  quality 
and  quantity.  If  it  were  possible  for  us  at  all  times  to 
know  what  is  at  fault,  to  be  at  hand  when  the  nutritive 
processes  first  begin  to  depart  from  physiological  paths,  and 
to  have  at  our  command  the  means,  together  with  a  right 
knowledge  of  their  application,  to  set  these  processes  right, 
both  our  pathology  and  our  therapeutics  would  reach  their 
ideal  stage.  But,  as  a  rule,  the  abnormal  goes  on  and  we 
often  recognize  it  only  at  a  later  stage,  and  here  it  is  that  we 
begin  our  process  of  repair,  if  perchance  repair  is  possible. 

The  deeper  the  insight  one  acquires  of  the  nature  of 
physiological  action  in  living  tissues,  and  of  the  causes 
and  influences  that  tend  to  divert  that  action  beyond  the 
limits  of  health,  the  more  simple  and  rational  will  be  the 
therapeutic  means  employed  to  remove  the  causes  and  check 
the  morbid  tendencies. 

Action  brings  waste,  and  time  and  rest  are  needed  for 
the  reconstruction  of  the  wasted  substance.  Often,  through 
disregard  of  physiological  laws,  repair  takes  place  slowly 
and  laboriously,  and  at  times  e\en  a  cessation  of  efforts  at 
repair  may  occur. 

The  nutrition  of  the  body  is  decided  by  the  quality  of 
circulation  in  the  minute  lymph  channels  outside  of  the 
capillary  walls.  It  is  through  these  channels  that  the 
stream  of  plasma  from  the  blood-  reaches  the  tissues,  and 
it  is  here  that  the  destructive  germ  or  poison  is  seized 
upon  by  the  phagocyte  and  torn  apart  to  be  digested ;  and 
the  detritus,  robbed  of  its  infecting  quality,  is  discharged 

151 


152  PRACTICAL    ELECTRO-THERAPEUTICS. 

into  the  blood  to  be  finally  eliminated.  The  minute  size, 
situation  and  function  of  these  channels  render  them  pe- 
culiarly susceptible  and  liable  to  obstruction.  Impurities 
which  readily  circulate  through  the  heart  and  arteries  with- 
out inconvenience  frequently  lodge  in  these  channels  and 
obstruct  them,  greatly  to  the  concern  of  the  organs  or  tissues 
affected. 

When  the  roadway  over  which  the  poisonous  products 
must  pass  is  clogged,  drug-stimulation  of  the  heart,  liver, 
kidney  and  spleen  frequently  does  not  meet  with  the  success 
we  desire,  and  nature  must  be  supplemented  and  comple- 
mented in  another  way. 

In  looking  about  for  possible  causes  of  disease  which 
might  interfere  with  the  flow  of  nerve  energy,  we  find 
contracted  muscles  playing  a  very  important  part.  The 
muscles  do  not,  as  a  rule,  contract  as  a  whole,  but  as 
separate  fibers  of  several  muscles,  which  accounts  for  the 
appearance  of  knotty  or  welt-like  masses  under  the  exam- 
ining finger. 

Contractures  of  muscles  or  muscle  bands  may  be  brought 
about  in  many  ways — the  most  common  cause  being  un- 
doubtedly change  in  temperature,  seasonal  and  climatic 
variations,  etc.  It  is  a  recognized  law  of  physics  that 
cold  contracts  and  heat  expands  muscular  texture.  These 
diametrically  opposite  states  are  prime  factors  in  the  pro- 
duction of  many  diseases.  They  influence  the  character  of 
the  changes  of  the  elements  that  take  place  in  the  system, 
as  well  as  the  circulation  of  the  fluids  that  contain  them  in 
solution. 

Thus  we  see  that  a  draught  of  cold  air  on  a  part  moist 
with  perspiration  may  be  the  starting  point  of  a  series  of 
abnormal  conditions,  and  a  common  cold  may  assume  a 
serious  phase  when  looked  upon  in  this  light.  Contrac- 
tures of  muscle  fibre  may  further  be  brought  on  by  a  con- 
stant irritation  of  the  nerve  supplying  the  contracted 
muscle.  This  irritation  may  be  caused  by  impure  blood 
due  to  faulty  elimination,  as  found  in  auto-intoxication, 
fatigue,  rheumatism,  grip,  malaria  and  similar  abnormal 
conditions.  Excessive  use  or  overwork  of  one  set  of 
muscles,  beyond  the  point  of  fatigue,  is  a  very  frequent  cause 
of  contracted  muscle  fibers.  Thickening  of  the  ligaments, 


PRACTICAL    ELECTRO-THERAPEUTICS. 


153 


following  some  strain,  wound  or  injury  may  act  mechanically 
in  shutting  down  upon  the  parts  and  cutting  off  blood 
and  nerve  supply.  It  is  a  common  thing  for  scar  tissue 


Receptaculum  Chyli;  Thoracic  and  Abdominal  Lymphatics. 

Study  of  this  chart  shows  why  the  deep  cervical  glands  on  the  left  side  are  always 
more  or  less  involved  in  auto-intoxication  from  intestinal  disorders. 

to  catch  some  nerve  filament  in  its  connective  tissue  and 
thus  cause  irritation  and  pain  when  it  begins  to  contract. 

That   contractures   of   fine   muscle   bands,   or   ligaments, 
may  be  the  cause  of  disease  and  not  the  result  is  also 


154 


PRACTICAL    ELECTRO-THERAPEUTICS. 


easily  demonstrated,  for  immediate  improvement  and  re- 
covery frequently  follow  the  removal  of  these  abnormal 
contractures. 


Glands  and  Lymphatics  of  Cervical  Region— Lymphatics  on  Posterior  of  Sternum. 

Nerve  tracing  and  spinal  localization  are  frequently 
worth  more  than  taking  the  pulse  and  respiration. 

Contractures  of  muscle  bands  interfere  with  the  dis- 
tribution of  lymph,  blood  and  nerve  impulse,  as  is  easily 


PRACTICAL    ELECTRO-THERAPEUTICS.  155 

noted  by  the  difference  in  the  temperature  of  the  parts, 
following  the  .distribution  of  certain  nerves.  The  action 
of  these  contracted  muscle  fibers  may  indeed  become 
traumatic,  in  certain  cases  wounding  a  nerve  or  setting 
up  nervous  trouble,  often  causing  degeneration. 

Pressure  from  a  contracture  upon  a  nerve  fiber  may 
cause  a  break  in  the  continuity  of  the  semifluid  axis 
cylinder  and  the  damming  back  of  its  current  upon  the 
center  of  supply ;  or  the  contracture  may  produce  slug- 
gishness in  the  flow  of  fluids,  thus  influencing  a  change 
in  the  nerve  structure  with  consequent  disturbance  of 
function. 

We  readily  appreciate  that  disturbances  must  follow  any 
interference  with  the  nervous  system,  when  we  realize 
that  the  sympathetic  nervous  system  controls  the  action 
of  the  motor  system,  and  that  in  turn  regulates' the  caliber 
of  the  arterial  system.  Contractures  induced  by  the  irrita- 
tion- of  a  nerve  through  a  sympathetic  filament  may  cause 
nerve  waste  to  go  on  to  the  extent  of  threatening  the 
destruction  of  the  body,  without  the  perceptible  sensation 
of  pain  or  even  the  knowledge  of  the  patient. 

The  irritation  upon  the  nerves  or  blood-vessels  may  be 
just  enough  to  act  on  the  ligamentous  structure  sufficiently 
to  irritate  them  to  the  extent  of  a  slight  hyperemia.  This 
condition,  if  long  continued  or  frequently  repeated,  may 
cause  an  increase  in  the  epithelium  and  connective  tissue 
of  these  parts. 

That  a  slight  irritation  may  cause  serious  trouble  is  ob- 
vious in  sprains  and  dislocations,  which  are  frequently 
worse  than  fractures  on  account  of  the  presence  of  thick- 
ened connective  tissue  following  the  subsidence  of  the 
inflammation.  An  irritation  at  any  given  point  causes 
nature  to  throw  a  greater  food  supply  to  this  point,  thereby 
causing  a  thickening  of  the  ligaments  binding  the  bones  or 
vertebrae  together.  Too  much  nerve  force  in  one  place 
reacts  on  the  muscles  there,  causing  them  to  contract.  Nerve 
force  acts  in  the  nature  of  a  stimulant  to  the  terminal 
sensory  nerves. 

A  muscular  contraction  anywhere,  no  matter  how  it  is 
brought  about,  is  a  constant  drain  on  our  stock  of  energy. 
If  the  contracture  becomes  one  of  a  chronic  nature,  tne 


156  PRACTICAL    ELECTRO-THERAPEUTICS. 

dissipation  of  energy  frequently  reaches  an  astonishing 
degree;  in  fact,  may  cripple  the  entire  system. 

The  brain  of  man  has  been  compared  with  a  power- 
house in  which  there  are  many  dynamos.  Wires  lead  out 
from  these  dynamos  to  all  parts  and  every  organ  of  the 
body.  The  various  organs  and  parts  of  the  body  have 
been  compared  to  motors  or  engines  that  keep  up  their 
action  by  the  energy  they  receive  over  the  wires  from  the 
dynamos  in  the  brain.  The  food  we  consume  is  a  fuel 
which  contains  latent  energy.  Digestion  prepares  this  fuel 
for  admission  into  the  blood.  The  blood  carries  it  to  the 
nerve  centers  or  dynamos,  where  much  of  it  is  finally  burned 
up,  consumed,  and  the  latent  energy  which  held  the  food 
together  in  its  fuel  form  is  transformed  into  nerve  energy, 
which  is  conducted  by  the  nerves  to  very  part  of  the  "human 
plant." 

All  known  phenomena  are  due  to  energy,  which  has 
different  forms  of  manifesting  itself.  Fuel  has  energy  in 
a  latent  state.  It  is  burned  in  a  furnace,  and  the  energy 
that  was  latent  becomes  manifest  by  being  transformed 
into  heat  and  mechanical  motion  through  a  steam-engine. 
The  dynamo  transforms  this  mechanical  motion  into  elec- 
tricity, and  as  long  as  the  medium  is  appropriate,  this 
energy  continues  to  manifest  itself  as  electricity. 

Energy  is  never  annihilated  or  lost ;  it  manifests  itself  in 
different  wave  lengths,  such  as  electricity,  heat,  light,  mag- 
netism and  nerve  force.  The  medium  and  surrounding  con- 
ditions determine  the  form  in  which  it  manifests  itself,  and 
what  is  known  as  nerve  force — that  which  performs  all  the 
functions  of  man — is  one  of  the  forms  of  manifested  energy. 
There  are  storage  centers  in  the  human  plant,  called  ganglia. 
Muscles  also  have  energy  stored  in  them,  but  all  such 
storage  centers  are  dependent  on  the  human  power-house. 

Every  process  carried  on  Jn  the  human  body  requires  a 
certain  amount  of  energy.  Every  organ  and  minute  part 
is  an  engine,  in  itself  powerless  to  perform  any  function 
whatever,  and  is  as  dead  as  an  engine  without  steam  or  a 
motor  without  electricity.  But  when  endowed  with  energy, 
each  part  does  its  work,  performs  its  function,  the  same  as 
an  engine  or  motor  when  properly  energized.  Every  organ 
acts  just  as  its  energy  supply  dictates.  If  the  function  of 


PRACTICAL   ELECTRO-THERAPEUTICS. 


157 


Distribution  of  Deep  and  Cutaneous  Nerves  on  Back  of  Trunk. 

a  part  is  normal,  it  is  because  the  dominating  supply  of 
energy  is  normal.  If  the  function  is  weak  of  feeble,  it  is 
because  the  energy  supply  is  feeble ;  also,  if  the  function 
is  "overdone  it  is  due  to  an  ovcrsupply  of  energy.  Disease 


158  .         PRACTICAL   ELECTRO-THERAPEUTICS. 

is  nothing  but  perverted  function,  due  either  to  nerve  pres- 
sure or  nervous  strain  or  exhaustion. 

Pressure  upon  a  leash  of  nerves  as  they  emerge  from 
the  foramina  of  the  spine  may  modify  their  function  greatly 
and  even  shut"  it  off  altogether.  Removal  of  this  pressure  is 
frequently  followed  by  so  rapid  a  cure  that  we  hesitate  and 
wonder  if  some  one  was  not  mistaken.  • 

The  dynamos  in  the  human  brain  are  intimately  connected 
by  conductors,  so  that,  when  an  organ  or  part  is  called 
upon  for  excessive  work,  the  dynamo  that  presides  over 
this  part  furnishes  the  excess  of  energy  needed  by  robbing 
all  of.  the  other  dynamos  of  their  energy  or  working  power. 
Thus  all  other  parts  of  the  body,  for  the  time  being,  must 
suffer  from  the  lack  of  the  functionating  power  they  are 
deprived  of.  Thus  an  organ  may  functionate  improperly 
without  it  or  its  dynamo  being  at  fault,  simply  because 
some  other  dynamo  is  taking  its  needed  energy  to  supply 
the  overtaxed  functions  of  some  other  organ. 

The  occasional  overtaxing  of  a  function  may  not  result 
in  much  observable  injury  to  other  parts ;  but,  through 
oft-repeated  and  continuous  experiences,  the  excessive  func- 
tion becomes  a  habit,  and  more  or  less  continuous  in  its 
excessive  demands  on  the  common  energy  fund,  continuously 
depriving  other  parts  of  a  healthy  functionating  power. 
Thus  we  can  readily  see  that  organs  can  be  diseased  without 
the  cause  being  in  them  or  their  governing  nerve  centers. 

To  illustrate,  we  may  have  a  small  lighting  plant  capa- 
ble of  furnishing  electricity  to  illumine  seventy  incandescent 
lamps  of  sixteen  candle  power  to  their  proper  brightness. 
Should  we,  however,  replace  one  sixteen-candle-power  lamp 
with  a  three-hundred-candle-power  lamp  we  would  imme- 
diately notice  a  marked  dimness  in  the  other  lamps.  Exami- 
nation would  show  nothing  amiss  with  our  dynamo,  nothing 
amiss  with  our  lamps,  especially  so  with  the  robber  which 
outshines  all  the  rest. 

A  similar  condition  may  and  frequently  does  exist  in  the 
human  body,  the  organ  at  fault  varying  with  the  individual. 
The  most  common  robbers  of  our  bank  of  energy  are  the 
eye,  the  stomach,  the  genital  organs  and  the  brain. 

Of  all  the  organs  in  the  body,  the  eyes  are  most  capable 
of  demanding  and  getting  an  excessive  share  of  the  general 


PRACTICAL   ELECTRO-THERAPEUTICS.  159 

fund  of  nerve  energy.  The  patient  frequently  finds  himself 
running  down,  and  when  referred  to  the  oculist  returns  with 
the  verdict  that  vision  is  perfect,  though  in  reality  the  eyes 
may  be  robbing  the  human  power-house  of  enough  energy  to 
cripple  the  wofk  of  every  organ  in  the  entire  body. 

Overwork  or  abuse  of  any  organ  causes  an  excessive 
action  of  the  secretory  and  trophic  nerves  supplying  it  to 
such  a  degree  that  they  appropriate  nearly  all  the  nerve  force 
given  off  by  the  nerve  trunk  from  which  they  spring.  This 
deprives  the  other  branches  of  their  normal  power,  and  the 
organs  that  they  supply  become  correspondingly  weakened. 
The  nerves  to  the  ligaments  that  hold  the  two  vertebras  of 
the  joint  in  place  and  prevent  them  from  slipping  and  press- 
ing against  their  nerve  trunk  are  among  the  smallest,  but 


Fig.  1.  Fig.  2. 

by  no  means  the  least-important  branches  (considered  eti- 
ologically)  of  the  spinal  nerve.  When  these  small  nerves 
are  unable  to  transmit  their  normal  amount  of  energy, 
owing  to  their  being  attracted  in  other  directions,  the  liga- 
ments settle  into  an  atonic  condition  that  renders  them  in- 
capable of  the  proper  performance  of  their  functions  and 
leaves  the  spinal  nerves  in  imminent  danger  of  irritation 
and  compression  by  the  displacement  of  the  vertebrae.  If 
slippage  occurs,  the  pressure  of  the  bone  shuts  off  a  portion 
of  the  nerve  current  in  the  already  weakened  nerve,  and 
precludes  the  possibility  of  cure  by  removal  of  the  primary 
cause  itself. 

Careful  scientific  investigation  shows  that  in  disease  of 
the  internal  organs  manifestations  of  this  condition  will  be 
made  by  tenderness  in  widely  removed  parts,  because  of 


160  PRACTICAL   ELECTRO-THERAPEUTICS. 

a  fixed  relationship  between  the  diseased  organ  and  the 
region  manifesting  the  tenderness.  Such  investigation  will 
reveal  the  fact  that  the  soreness  is  not  in  most  instances 
associated  with  the  skin  alone,  but  that  the  tenderness  is 
found  in  the  underlying  muscle  beneath.  The  physiologist 
explains  the  association  between  topographical  tenderness 
and  visceral  disorders,  by  the  assumption  that  the  nerves 
supplying  the  regions  thus  related  have  their  origin  within 
the  same  segment  of  the  spinal  cord. 

On  examining  the  spine  we  frequently  find  that  a  slight 
contraction  of  spinal  muscles  has  caused  the  spinous  pro- 
cesses to  deviate  a  little  to  the  right  or  to  the  left  of  the 
ones  above  or  below.  Spinous  processes  may  protrude  be- 
yond the  general  outline  posteriorly,  and  in  some  instances 
merely  a  depression  shows  the  location  of  the  spinous  pro- 
cess. The  bones  may  have  moved  on  their  axes,  either  to 
the  right  or  left,  or  have  been  pulled  slightly  forward  or 
backward,  a  condition  that  must  necessarily  pull  the  sur- 
rounding structure  with  it  and  cause  pressure  on  the  blood- 
vessels and  nerves  passing  under  or  into  them,  thus  abridg- 
ing their  function.  These  deviations  from  the  normal  may 
be  traced  back  to  some  slight  traumatic  injury,  exercise 
persisted  in  after  fatigue  or  some  previous  disease  which  so 
affected  the  muscles  along  the  spine  as  to  cause  them  to 
pull  the  vertebrae  to  one  side.  A  previous  illness  may  pri- 
marily have  affected  the  spinal  centers  and  they  acting  re- 
reflexly  would  naturally  communicate  the  trouble  to  the 
muscles  supplied  by  the  nerves  arising  from  that  same  por- 
tion of  the  cord.  The  muscles  on  one  side  of  the  spine  are 
frequently  atrophied,  and  under  such  conditions  a  tonic  con- 
traction of  the  opposite  muscle  is  sufficient  to  pull  the  bones 
to  that  side.  Slight  irritation  of  a  nerve  by  the  pressure  of 
a  distorted  vertebra,  throws  too  much  blood,  nerve  force  and 
life  to  this  spot  thus  affected,  setting  up  an  irritation  which, 
if  long  continued,  results  in  a  thickening  of  the  ligaments 
and  perhaps  permanent  injury  to  the  parts  concerned.  Con- 
stant irritation  or  stimulation  in  a  region  of  high  sensibility 
inclosing  central  connection  with  a  viscus  will  produce 
both  functional  and  structural  disturbances  in  the  viscus, 
as  well  as  sensitiveness  in  the  region  irritated. 

Consider,  for  example,  the  action  of  disease  of  the  liver, 


PRACTICAL    ELECTRO-THERAPEUTICS. 


161 


Diagram  cf  Spinal  Nerves  and  Plexuses 

spleen  or  lungs  upon  its  area  of  the  spinal  column.  Irrita- 
tion of  the  liver  is  frequently  reflected  to  the  right  inter- 
costal muscles,  causing  them  to  contract.  It  will  then  be 
found  that  the  ligaments  and  muscles  at  the  spinal  attach- 
ment of  the  involved  ribs  are  irritated  as  disclosed  by  ex- 
11 


PRACTICAL   ELECTRO-THERAPEUTICS. 

treme  sensitiveness  to  deep  pressure.  The  circulation  with- 
in the  cord  throughout  the  irritated  area  becomes  more  or 
less  compromised  and  lowered  nutrition  of  both  nervous 
and  muscular  elements  speedily  follows.  The  muscles  lose 
their  power  to  longer  maintain  the  spine  in  proper  equilib- 
rium, in  which  case  the  spine  will  be  slightly  deviated  to  the 
opposite  side. 

If  the  spleen  were  the  seat  of  irritation  or  disease,  substan- 
tially the  same  resulting  pathological  condition  would  be 
established  upon  the  opposite  (left)  side  of  the  body.  The 
same  involvement  of  ribs,  muscles  and  ligaments  would  oc- 
cur, but  with  even  more  distressing  and  disastrous  conse- 
quences. The  reason  for  this  is  obvious,  when  it  is  remem- 
bered that  the  contracted  muscles  in  the  area  on  this  side 
may  inhibit  nerves  which  control  the  functionation  of  the 
pancreas  and  that  these  nerves  are  also  liable  to  reflect  its 
pernicious  influence  to  the  sympathetic  nerves  which  control 
the  secretion  of  the  digestive  juices  of  the  stomach,  and  may 
affect  the  action  of  the  heart.  In  irritations,  therefore,  of  the 
dorsal  region  on  the  left  side,  it  is  by  no  means  rare  to 
find  in  association  the  following  symptoms:  Hyperacidity 
and  flatulency  in  stomach  and  intestines,  gastric  catarrh  due 
to  a  disturbance  in  the  secretion  of  hydrochloric  acid  in 
proper  proportion,  pain,  impaired  digestion  and  assimilation. 
In  the  above  conditions,  points  of  tenderness  will  be  found  at 
the  angle  of  the  ribs,  and  treatment  should  be  applied  ac- 
cordingly. 

If  the  irritation  should  happen  to  be  located  in  the  right 
lung  or  pleura,  it  might  be  communicated  to  the  intercostal 
muscles.  The  ribs  would  become  depressed  and  the  same 
spinal  condition  already  described  might  ensue;  but  there 
frequently  occurs  also  in  this  connection,  pain  in  the  deltoid 
region,  shoulder  joint  and  arm,  with  more  or  less  impairment 
of  function.  The  reason  for  this  will  be  readily  evident  by 
recalling  the  anatomical  fact  that  a  branch  from  the  second 
and  third  intercostal  nerves  communicates  with  the  arm,  and 
the  sympathetics  of  this  area  influence  the  nutrition  of  the 
parts  above  mentioned. 

A  depression  of  the  clavicle  caused  by  contractured  mus- 
cles may  bring  pressure  to  bear  on  the  nerves  or  blood- 
vessels passing  between  it  and  the  first  rib,  and  be  the  cause 
of  a  series  of  very  unpleasant  symptoms. 


PRACTICAL   ELECTRO-THERAPEUTICS. 


Spinal  Nerves  and  Flexures,  with  the  Sympathetic  Nerve  Connections. 


164  PRACTICAL    ELECTRO-THERAPEUTICS. 

As  in  the  spine,  abnormalities  may  occur  in  the  ribs  at  any 
point  through  the  thorax.  The  most  frequent  abnormality 
of  a  rib  is  a  depression  of  its  sternal  end.  This  is  invariably 
followed  by  irritation  of  the  intercostal  nerve  and  its 
branches,  interference  with  the  intercostal  circulation  due  to 
compression  of  the  vessels,  and  irritation  of  the  muscles  and 
ligaments  at  the  attachment  of  the  rib  to  the  vertebra.  If  a 
rib  is  deflected,  its  edge  may  be  easily  detected  by  comparing 
it  with  the  flat  surface  of  a  normal  rib,  or  comparing  it 
with  the  same  rib  on  the  opposite  side. 

The  correction  of  malposition  should  be  one  of  the  first 
steps  taken  to  bring  about  a  cure. 


Roots  and  Origin  of  the  Seventh  Dorsal  Nerve. 

Many  semi-invalids  who  are  not  really  ill,  but  at  the  same 
time  do  not  possess  a  satisfactory  degree  of  health,  owe  their 
condition  to  their  avocation  or  occupation  which  tends  to 
an  undue  and  disproportionate  activity  of  some  parts  of  the 
physical  system  to  the  detriment  of  others,  and  this  partial 
lack  of  functional  activity  may  be  a  potent  cause  of  ill  health 
on  account  of  the  relaxed  or  contracted  condition  of  certain 
muscle  fibers  or  muscles  on  certain  nerves. 

There  are  cases  every  day  under  the  physician's  observa- 
tion, presenting  conditions  that  have  endured  from  child- 
hood, which  predispose  to  abnormalities  in  adult  life  and  are 
due  to  easily  recognizable  disturbances  of  the  nervous  me- 
chanism of  different  parts  of  the  body.  If  these  conditions 
are  corrected,  and  if  nature  is  only  in  a  measure  helped  over 


PRACTICAL   ELECTRO-THERAPEUTICS.  165 

the  hard  places,  she  will  take  charge  of  matters  and  we  can 
feel  assured  that  the  ultimate  result  will  be  satisfactory. 

A  flabby  muscle  is  usually  an  indication  that  the  disease 
has  progressed  to  a  considerable  degree. 

The  gravity  of  an  injury  along  the  spine  does  not  depend 
upon  its  great  extent,  as  a  slight  twist  may  cause  a  great- 
deal  of  trouble,  while  a  deformed  spine  may  be  congenital 
and  cause  no  trouble  whatever.  It  is  not  the  .extent  of  the 
injury  to  the  spine  that  determines  its  gravity,  but  the 
amount  or  intensity  of  nerve  force  displayed  at  any  given 
point.  Degeneration  may  follow  a  slight  lesion  of  the  nerves, 
such  as  compression,  over-extension  and  the  like.  The  sepa- 
rating of  the  molecules  in  the  white  substance  of  Schwann 
may  have  the  effect  of  setting  up  a  secondary  degeneration 
similar  to  that  resulting  from  a  division  of  nerves.  It  is  im- 
possible to  send  a  communication  over  an  electric  wire  with- 
out continuity  of  contact.  Similarly  it  is  necessary  to  have 
perfect  freedom  of  communication  along  a  nerve  between  the 
terminal  end  and  the  nerve  center. 

Briefly  stated,  the  nervous  system  which  unites  and  co- 
ordinates the  various  organs  and  tissues  of  the  body  and 
brings  the  individual  parts  into  relationship  with  the  external 
world  is  arranged  in  two  systems  termed  the  cerebrospinal 
and  the  sympathetic  systems,  working  in  harmony  with 
each  other. 

The  cerebrospinal  system  consists  of  the  brain,  spinal 
cord  and  the  nerves  emanating  from  them,  and  controls 
motion  and  sensation. 

The  sympathetic  system  consists  of  a  double  chain  of 
nerve  centers,  connected  by  nerves  situated  on  each  side 
anteriorly  of  the  spinal  column  extending  from  the  base  of 
the  skull  to  the  end  of  the  coccyx,  and  communicating  with 
the  cerebrospinal  system.  It  is  the  center  of  the  vasomotor 
system  and  is  the  central  station  for  reflexes  ;  it  automatically 
exercises  action  and  control  over  the  circulation  and  func- 
tionation  of  the  several  viscera.  It  serves  as  an  indicator 
of  abnormal  action  in  the  various  organs  of  the  body,  the 
indication  being  manifested  in  the  muscles  overlying  the  an- 
terior branch  of  the  spinal  nerve,  through  contraction  and 
muscular  irritation.  The  sympathetic  system  controls 
nutrition,  growth,  secretion,  and  modifies  the  action  of  the 
other  set  of  nerves. 


166  PRACTICAL   ELECTRO-THERAPEUTICS. 

A  careful  study  of  the  nervous  system  will  be  amply  re- 
paid. So  far-reaching  and  important  are  the  effects  of  the 
nervous  system  upon  the  physical  well-being  of  mankind, 
that  a  careful,  comprehensive  study  of  its  manifold  functions 
is  in  every  case  a  forerequisite  to  intelligent  diagnosis.  There- 
fore, as  a  lawyer  consults  his  authorities  before  venturing  an 
opinion,  so  also  should  the  physician  consult  his  anatomy  and 
physiology  before  beginning  the  treatment  of  any  particular 
case. 

The  circulation  of  the  blood  is  under  the  influences  of  the 
vasomotors,  the  nerves  which  primarily  control  the  functions 
of  the  cerebrospinal  system.  The  vasomotor  nerves  are  of 
two  kinds,  vasoconstrictors  and  vasodilators,  being  dis- 
tributed chiefly  to  viscera  and  cutaneous  vessels.  The  vaso- 
constrictors decrease  the  lumen  of  the  blood-vessels  and  be- 
ing in  a  state  of  constant  action,  they  bring  about  a  tonic  or 
hypertonic  effect.  They  act  both  locally  and  generally.  In 
addition  to  the  general  vasomotor  center  in  the  medulla,  there 
are  subsidiary  centers  located  at  the  varying  levels  of  the 
spine  or  the  true  vasomotor  reflex  centers. 

Constriction  of  the  arteries  produces  a  diminished  flow 
of  blood  through  these  main  channels,  as  this  influence 
leads  to  an  increased  flow  of  blood  through  the  veins.  Vas- 
oconstriction,  by  increasing  the  resistance  to  the  blood 
passing  from  the  arteries  into  the  capillaries  and  veins, 
increases  the  work  of  the  heart — the  effect  being  propor- 
tionate to  the  degree  of  constriction  and  area  affected. 
The  increased  amount  of  work  may  however  be  counter- 
balanced by  diminished  arterial  tone  in  some  other  part 
of  the  organism,  chiefly  through  the  inhibition  of  the  vaso- 
constrictors of  the  abdominal  splanchnic. 

Arterial  tone  is  the  result  of  the  condition  of  the  blood 
which  stimulates  the  vasomotor  centers,  and  of  the  gen- 
eral relation  between  the  thermogenic  and  the  thermolytic 
centers.  Any  stimulation  or  irritation  of  a  sensory  nerve 
will  increase  the  action  of  the  vasomotors. 

The  vasodilators  increase  the  lumen  of  the  blood-vessels 
and  act  locally;  they  diminish  the  blood  pressure  every- 
where, the  general  fall  being  proportionate  to  the  area 
dilated  and  the  amount  of  dilation.  Their  most  marked 
effect  is,  however,  to  flush  out  the  capillaries  in  the  dilated 


PRACTICAL   ELECTRO-THERAPEUTICS.  167 

areas.  The  vasodilators  are  chiefly  distributed  to  skeletal 
muscles  and  to  other  local  structures  and  glands. 

It  must  not  be  forgotten,  however,  that  there  are  vas- 
omotor  reflexes  in  the  sympathetic  centers  which  control 
the  rhythmic  activity  of  many  vessels  of  the  body  during 
health. 

When  we  bear  in  mind  the  fact  that  the  heart  is  closely 
connected  with  the  sympathetic  system,  we  realize  that 
trouble  almost  anywhere  may  have  an  important  effect  on 
the  heart  and  circulation.  Thus  it  is  a  well-known  fact  that 
irritation  in  the  rectum,  accompanied  by  a  contracted 
sphincter  ani,  may  in  some  cases  cause  a  rapid  and  irregular 
heart.  Dropping  of  the  acromial  end  of  the  clavicle  may 
mechanically  shut  down  the  circulation  through  the  sub- 
clavian  veins,  and  among  other  symptoms  may  cause  an 
angina  pectoris.  In  examining  to  find  the  cause  of  an  irreg- 
ular heart,  it  is  well  to  examine  not  only  the  heart,  but 
everything  which  might  affect  a  vessel  coming  from  it.  The 
clavicle  and  the  first  and  second  ribs  are  a  frequent  cause  of 
trouble,  on  account  of  their  attachment  to  the  scalene  mus- 
cles. Contractures  of  these  muscles  (rheumatic  or  other- 
wise) tend  to  draw  the  ribs  upward  and  thereby  bring 
pressure  to  bear  upon  some  of  the  blood-vessels  or  cause 
interference  with  the  nerves  of  their  spinal  attachment. 

Mild  mechanical  stimulation  of  the  centers  in  the  spine 
from  the  third  cervical  to  the  fifth  dorsal  increases  rapidity 
and  force  of  the  heart-beat  and  contraction  of  the  blood- 
vessels. 

The  heart's  action  may  be  slowed  by  inhibition  or  pres- 
sure exerted  in  the  superior  cervical  region.  Pressure  on 
the  spinal  nerve  inhibits  the  impulses  from  entering,  and 
thus  allays  outgoing  ones.  The  sensory  fibers  of  the  heart 
arise  from  the  upper  dorsal  region.  Removal  of  any  irrita- 
tion to  these  will  quiet  an  excited  condition  of  the  heart. 
Relaxation  of  these  muscles  in  first,  second  and  third  dorsal 
will  also  frequently  quiet  an  excited  condition  of  the  heart. 
Thus  raising  the  left  arm  and  lifting  the  clavical  with 
pressure  exerted  in  interscapular  region  often  allays  palpita- 
tion of  heart  instantaneously. 

The  restraining  influence  of  the  centers  in  the  medulla 
may  be  reflexly  increased  by  stimulation  of  almost  any 


168  PRACTICAL   ELECTRO-THERAPEUTICS. 

afferent  nerve,  particularly  the  abdominal  sympathetic,  pro- 
ducing slowing  or  stoppage  of  the  heart  through  impulse 
from  it  passing  down  through  the  vagi. 

In  acute  cases  and  usually  as  preparatory  treatment  in 
chronic  condition  it  is  necessary  to  reduce  muscular  con- 
traction. This  muscular  contraction  is  in  many  cases  a  re- 
flex effect  of  stimulation  of  branches  of  afferent  nerves, 
other  branches  of  which  are  distributed  to  the  muscles  of 
the  spine. 

The  arteries  of  the  several  regions  of  the  spine  supply 
both  the  cord  and  the  spinal  muscles — the  same  branch 
dividing  to  supply  both.  Physiologists  tell  us  that  there 
is  an  inverse  relation  between  the  vessels  of  the  superficial 
and  those  of  the  deeper  structures.  This  being  the  case 
we  see  that  the  contracted  muscle  on  the  surface,  by 'closing 
or  lessening  the  size  of  the  lumen  of  these  vessels,  causes 
the  oversupply  to  be  sent  over  the  other  branch,  producing 
a  hyperemic  condition  in  the  cord.  This  hyperemia  of 
the  cord  leads  to  an  abnormal  activity  of  the  parts  immedi- 
ately controlled  from  this  area.  The  contractions  of  the 
muscles  may  have  primarily  been  the  result  of  changed  con- 
ditions in  the  viscera.  Nevertheless  the  removal  of  these 
contractures  tends  to  restore  a  normal  circulation  to  the 
organs  through  the  vasomotor  effect. 

The  sympathetics  are  the  great  vasoconstrictors  and 
viscero  inhibitors  to  the  solar  plexus  and  its  related  plex- 
uses. Pressure  on  the  solar  plexus  quiets  an  over-excited 
heart  and  thus  aids  in  equalizing  the  circulation.  Vibratory 
pressure  brought  to  bear  upon  the  splanchnics  and  mesen- 
teric  vessels  causes  them  to  become  constricted,  the  reverse 
condition  following  in  the  cutaneous  capillaries.  It  is  im- 
portant to  remember  this,  as  it  serves  to  regulate  the  tem- 
perature by  irradiation  and  evaporation  of  the  products  of 
the  perspiratory  glands.  The  thermogenic  center,  located 
in  the  corpus  striatum,  may  be  influenced  by  pressure 
exerted  upon  the  vertebral  artery,  aided  by  downward  pres- 
sure upon  the  sheath.  This  causes  less  blood  to  be  sent  to 
this  center,  aids  drainage  and  assists  in  reducing  tempera- 
ture. 

Stimulation  of  the  vagus  relaxes  the  heart  muscle  and 
slows  down  the  heart-beat,  dilates  vessels  and  gives  them 
more  time  to  repair  waste. 


PRACTICAL   ELECTRO-THERAPEUTICS.  169 

Pressure  exerted  on  the  basi-occiput  reduces  the  flow  of 
blood  to  the  brain ;  quiets  the  irritated  meningeal  nerves ; 
reduces  pressure  in  the  arterial  twigs  which  nourish  the 
vasomotor  centers ;  modifies  the  rate  of  the  heart  by  dimin- 
ishing the  impulses  from  the  augmentor  center  situated 
near  the  vasomotor  center  in  the  medulla. 

There  is  an  extensive  field  for  the  application  of  electro 
vibration,  and  experience  has  shown  that  the  physician  who 
is  master  of  the  known  facts  of  physiology  and  anatomy 
\vill  often  be  able  to  give  immediate  relief  from  pain  by  the 
simple  application  of  the  well-known  law  of  physiology, 
that  pure  blood  and  normal  nerve  supply  give  health. 

In  manual  massage  it  is  necessary  to  know  when  to  em- 
ploy the  various  movements  necessary  for  success.  So,  also, 
is  it  essential  to  success  that  the  operator  of  an  electric 
vibrator  shall  employ  the  various  vibrations  suited  to  the 
parts  and  adapted  to  the  relief  of  the  pathological  changes 
to  be  overcome. 

It  is  strongly  urged  that  the  novice  operate  first  on  him- 
self before  attempting  the  treatment  of  the  patients,  that 
he  may  obtain  a  true  significance  of  the  various  vibrations ; 
otherwise  he  may  do  them  irreparable  injury. 

For  the  application  of  vibration  in  a  scientific  manner  it 
is  absolutely  necessary  to  know  the  normal  human  body 
in  order  to  permit  the  recognition  of  any  abnormal  con- 
dition or  even  slight  deviation  from  the  normal.  It  is  also 
of  vast  importance  to  know  the  various  centers.  Reasoning 
according  to  centers  is  frequently  going  from  effect  to 
cause,  from  periphery  back  to  center  and  vice  versa.  Even 
if  the  lesion  has  been  found  to  be  in  some  particular  organ, 
the  particular  center  governing  the  affected  part  should 
receive  attention.  Go  over  your  patient  carefully ;  find  out 
if  one  or  more  muscles  are  contracted ;  if  so,  do  they  draw 
across  important  blood-vessels  or  nerves.  Examine  all  the 
joints,  ribs,  clavicles  and  other  suspected  trouble  sources. 
Do  not  be  carried  away  by  general  symptoms.  Pain  upon 
the  surface  of  the  body,  not  accompanied  by  any  rise  of 
temperature,  may  indicate  a  distant  origin  of  the  trouble, 
usually  in  the  spine.  The  seat  of  pain  is  not  always  the 
seat  of  the  lesion.  When  there  is  an  impingement  upon  the 
origin  of  a  nerve,  the  pain  may  be  referred  to  the  distribu- 
tion upon  the  muscle  or  surface  of  the  body. 


170 


PRACTICAL    ELECTRO-THERAPEUTICS. 


Overall's  Rotary  Vibrating  Handle. 


PRACTICAL   ELECTRO-THERAPEUTICS.  1?1 

If  the  pain  is  in  the  head,  find  out  if  there  is  pressure 
upon  the  nerve  ending  in  the  painful  part,  or  if  it  is  due  to 
an  impingement  of  nerves  ending  in  the  stomach.  If  the 
latter  is  the  case  it  is  plainly  discernible  that  the  spine  needs 
attention  at  one  of  the  splanchnics  ending  in  the  solar 
plexus.  This  treated,  the  pain  in  the  head  usually  ceases. 

The  author  had  a  patient  who  complained  of  a  chronic 
pain  in  the  upper  right  side  of  her  head,  which  bore  a  close 
relation  to  a  rheumatic  affection  of  the  left  leg.  Pain  in 
the  head  disappeared  on  treating  the  limb  in  which  the 
pain  had  seemed  trivial  in  comparison  to  her  headache. 
As  illustrated  by  this  case,  contractures  and  pain  in  dis- 
tant parts  are  none  too  trivial  to  overlook. 

Failure  or  success  depends  on  the  skill,  technique  and 
the  intelligence  of  the  operator. 

No  set  rules  can  be  made  as  to  the  methods  which  will 
be  applicable  in  all  cases,  any  more  than  it  is  possible  to 
prescribe  a  given  drug  for  universal  symptoms.  Treat- 
ments and  methods  must  vary  according  to  the  cases 
treated;  some  cases  must  be  treated  longer  than  others. 
A  treatment  of  fifteen  minutes  may  be  required  by  one 
patient,  while  a  few  minutes  will  suffice  for  another.  Always 
begin  with  mild  pressure  on  vibratode,  giving  a  soothing 
effect,  and  gradually  work  up  to  the  required  intensity. 

In  most  cases  it  is  advisable  for  the  patient  to  be  clad 
in  a  loose  robe,  and  all  parts  except  those  treated  should 
be  covered.  There  should  always  be  an  interval  of  about 
an  hour  between  the  time  of  treatment  and  the  previous 
meal. 

There  are  three  important  factors  to  be  borne  in  mind 
in  the  administration  of  vibration :  Stroke,  speed  and  pres- 
sure. Each  of  these  has  a  modifying  effect  on  the  other. 

The  stroke  should  always  be  graduated  to  the  parts 
treated  and  speed  to  the  indication  of  the  case. 

Increasing  the  speed  increases  the  effect  and  alters  the 
quality  of  the  vibration,  making  it  either  slow  and  coarse 
or  fast  and  fine. 

Pressure  causes  deeper  penetration  and  diffusion  of  vi- 
bration. Light,  moderate  or  heavy  pressures  are  modified 
by  the  length  of  the  stroke  and  the  speed  of  the  machine. 
Great  speed  with  medium  stroke  may  produce  the  same 
effect  as  slow  speed,  short  stroke  and  great  pressure. 


172  PRACTICAL    ELECTRO-THERAPEUTICS. 

Pressure  of  an  alternating  character  lightly  applied  is 
stimulating  (tickling  of  the  skin,  for  instance),  its  action 
is  like  the  make  and  break  in  an  electrical  current.  Stimu- 
lation if  performed  too  long  or  too  hard  will,  after  it  has 
run  its  course,  result  in  the  nerve  refusing  to  respond  to 
any  stimulus  or  irritation.  The  degree  of  force  must  be 
applied  in  proportion  to  the  degree  of  irritability  of  the 
different  parts  of  the  body  and  must  be  greatest  in  the  least 
irritable  parts.  Always  bear  in  mind  that  motor  nerve 
fibers  are  paralyzed  sooner  than  sensory  nerves  by  con- 
tinuous pressure.  Also  that  light  pressure  stimulates  and 
that  heavy  pressure  lessens  nerve  conductivities,  induces 
sedation,  benumbing  and  eventually  paralyzing  the  parts. 
Thus  we  see  that  inhibition  consists  in  an  exaggeration  of 
a  stimulating  effect  prolonged.  . 

The  patient  should  always  assume  a  relaxed  position 
during  treatment ;  in  fact,  it  should  be  our  effort  to  bring 
about  relaxation  of  contracted  tissue  by  means  of  vibration 
before  giving  a  stimulating  treatment.  Interrupted  vibra- 
tion with  deep  pressure  against  the  grain  of  the  muscles 
will  usually  cause  the  contracted  muscle  to  relax. 

Those  points  which  respond  best  to  the  faradic  current 
are  likewise  the  ones  which  respond  most  energetically 
to  mechanical  stimulation. 

Stimulation  applied  to  a  motor  nefve,  instead  of  mus- 
cle, brings  about  a  greater  contraction,  and  one  whose 
duration  increases  according  to  the  nearness  of  the  cord 
to  the  point  at  which  the  stimulus  is  applied  to  the  nerve. 

Stimulation  of  the  specific  end  organ  of  an  afferent 
nerve  more  easily  produces  a  complex  movement  than 
stimulation  of  its  trunk. 

Stimulation  of  a  nerve,  or  nerve  center,  causes  imme- 
diate results  inducing  muscular  contraction  and  dilation 
of  the  blood-vessels,  permitting  the  vessels  to  empty  them- 
selves and  let  new  fluids  rush  in.  The  chemical  changes 
that  take  place  are  manifested  by  the  glow  of  the  tissues 
and  the  well-being  of  the  patient. 

It  is  a  scientific  fact  easily  demonstrated  that  the 
equilibrium  between  the  nervous  system  and  subordinate 
tissue  can  be  maintained  by  mechanical  influences. 

Normal   function   and   secretions  can  be  brought  about 


PRACTICAL  ELECTRO-THERAPEUTICS. 


173 


by  stimulating  the  nerve  filaments  and  centers  which  con- 
trol the  circulation  of  the  fluids  to  these  organs,  as  well 
as  the  centers  which  control  the  elimination  of  toxic 
materials  from  the  body. 

In  applying  stimulation  to  the  spinal  centers  we  use 
the  ball  vibratode  and  apply  it  on  either  side  of  the  spine 
between  the  transverse  processes,  being  careful  to  avoid 
the  spinous  processes.  The  impulse  thus  set  up  is  commu- 
nicated at  the  juncture  of  the  anterior  and  posterior  roots 


Betz  Vibrator. 

in  the  intervertebral  foramen  to  the  anterior  division  of  the 
spinal  nerve,  and  on  through  the  rami  communicates 
to  the  sympathetic  nerve.  Duration  of  application  is  twelve 
to  fifteen  seconds.  The  tendency  of  the  beginner  is  to  treat 
the  patient  too  long  or  too  often. 

Massage  and  mechanical  exercise  have  been  maturing  as 
therapeutic  measures  for  centuries,  until  they  are  now 
placed  on  a  well-defined  physiological  basis  and  have  at- 
tained a  high  and  definite  place  in  therapeutics.  Vibratory 
friction  of  more  recent  origin  makes  application  of  the  prin- 
ciples of  scientific  massage.  The  invention  and  use  of 


174  PRACTICAL   ELECTRO-THERAPEUTICS. 

the  electric  vibrator  make  the  application  of  these  laws  of 
physiology  much  less  laborious  than  manual  massage,  and 
may  be  used  in  place  of  manual  massage  where  the  physi- 
cian does  not  have  the  assistance  of  a  skilled  masseur.  The 
results  of  vibratory  friction  as  applied  in  office  practice 
can  not,  however,  be  compared  to  those  following  scientific 
manual  massage  as  given  by  a  first-class  operator. 

In  applying  vibratory  friction  the  patient  should  lie  on 
the  table  perfectly  relaxed,  as  muscular  tension  interferes 
with  the  effect  sought.  It  is  applied  by  moving  the  multiple 
point  or  brush  vibratode  over  the  various  parts  of  the 


Kelley  Bedside  Vibrator  and  Case. 

body  with  varying  degrees  of  pressure  suited  to  the  par- 
ticular part  or  condition  under  treatment.  If  the  skin  is 
delicate,  talcum  powder  should  be  dusted  over  the  surface. 

Vibratory  friction  has  a  marked  influence  on  the  lym- 
phatic circulation.  It  causes  more  leucocytes  to  become 
phagocytes ;  breaks  up  minute  adhesions,  thereby  permitting 
a  freer  circulation  and  drainage,  which  naturally  increases 
bodily  resistance.  The  lymphatic  vessels,  most  numerous  in 
the  muscles  fascia  between  and  around  the  muscle  in  the 
subcutaneous  tissue,  are  readily  acted  upon  by  vibratory 
friction,  but  the  lymphatics  of  the  neck,  the  mesenteric, 
mediastinal,  axillary,  inguinal,  popliteal  and  cervical  gland 
should  receive  especial  attention  in  all  cases  of  faulty  met- 


PRACTICAL   ELECTRO-THERAPEUTICS.  175 

abolism.  Bacteria  reside  mostly  in  the  lymphatics,  and 
recent  investigation  has  demonstrated  .that  bacteria  can 
not  withstand  continuous  vibration. 

Experiments  have  demonstrated  greatly  increased  ex- 
cretion of  moisture,  as  well  as  dissipation  and  elimination 
of  heat,  as  a  result  of  vibratory  treatment. 

Vibratory  friction  is  an  important  aid  in  the  treatment 
of  inflammatory  conditions,  hastening,  as  it  does,  the  elim- 
ination of  toxic  material  and  promoting  the  absorption  of 
local  edema.  The  increased  blood  supply  following  the 
removal  of  obstructions  increases  the  nutritional  activity 
of  the  parts,  rendering  them  more  firm,  more  elastic. 
Following  an  injury,  vibratory  friction  rapidly  diminishes 
the  tense  hardness  due  to  local  stasis  and  removes  the 
thickening  of  the  ligaments,  tendinous  and  muscular  parts 
when  the  function  of  a  limb  is  impaired. 

When  we  realize  the  fact  that  twenty-five  per  cent,  of 
all  the  blood  in  the  body  is  contained  in  the  muscular 
structure  and  all  metabolic  processes  depend  on  muscular 
energy,  we  appreciate  the  necessity  of  having  these  tissues 
in  a  normal  healthy  condition. 

Vibratory  friction  may  be  followed  by  the  application 
of  the  roller  vibratode  applied  with  moderate  pressure  and 
speed,  as  it  produces  heat  and  stimulates  functional  cellular 
activity. 

Vibratory  stroking,  lightly  applied  with  a  short  stroke 
but  great  speed,  has  a  sedative  and  soothing  action  and  is 
indicated  in  cases  of  neurosthenia,  insomnia  and  like  dis- 
orders. 

In  separating  approximated  ribs  place  the  disk  vibra- 
tode, adjusted  to  its  shortest  possible  stroke,  at  the  poste- 
rior angle  of  the  rib — that  is,  an  inch  and  a  half  or  two 
inches  from  the  spinous  processes — and  bring  pressure 
to  bear  at  this  point.  The  operator  puts  the  other  hand 
over  the  patient's  shoulder,  well  down  on  the  thorax  ante- 
riorly and  lifts  at  this  point.  This  serves  to  spread  the  ribs 
apart,  and  if  the  muscles  have  been  thoroughly  relaxed 
they,  will  remain  apart  until  further  irritation  causes  the 
muscles  to  contract  and  brings  them  together  again. 

Depression  of  ribs  at  their  sternal  end,  brought  about 
by  the  act  of  coughing,  or  through  violent  contractions  of 


176  PRACTICAL   ELECTRO-THERAPEUTICS. 

the  diaphragm,  may  usually  be  drawn  into  place  by  stimula- 
tion and  consequent  contraction  of  the  pectoral  muscle. 
Vibration  of  the  ribs  themselves  sometimes  relieves  the 
spinal  contracture  and  permits  the  parts  to  assume  a  nor- 
mal position. 

As  a  large  part  of  diseased  conditions  have  their  origin 
in  the  digestive  tract,  it  is  a  matter  of  no  small  import 
that  physicians  know  the  nerve  influences  which  carry  on 
the  various  processes  of  digestion  and  assimilation. 

Nausea  and  vomiting  are  frequently  relieved  by  firm 
pressure  exerted  over  the  solar  plexus.  Pressure  applied 
an  inch  to  the  right  of  the  fourth  dorsal  vertebra  relaxes 
the  pyloric  orifice  of  the  stomach,  permitting  the  offending 


Atlantic  City  Portable  Vibrator. 

material  to  find  exit  into  the  intestinal  canal,  which  as  soon 
as  accomplished  causes  nausea  to  disappear.  By  placing  the 
patient  on  his  right  side  with  knees  well  elevated,  the 
stomach  being  filled  with  water,  the  operator  can  readily, 
with  the  left  hand,  raise  the  stomach  and  empty  its  contents 
into  the  small  intestines  after  having  opened  the  pylorus. 

Hiccough. — Inhibition  exerted  on  the  nerve  on  each  side 
of  the  neck  just  above  the  collar-bone,  or  against  front 
part  of  transverse  processes  of  third,  fourth  and  fifth  cervi- 
cal vertebrae,  frequently  gives  instant  relief. 

Atonic  Dyspepsia. — The  cure  of  this  trouble  must  be 
brought  about  by  supplying  good  healthy  blood  to  the 
diseased  structures  all  along  the  intestinal  tract.  Deficien- 
cies in  the  proportion,  quantity  and  quality  of  the  glandular 
secretions  are  directly  attributable  to  some  trouble  in  the 


PRACTICAL    ELECTRO-THERAPEUTICS.  177 

nervous  system  which  controls  the  organs  in  these  loca- 
tions. 

The  necessity  of  perfect  freedom  from  pressure  is  ap- 
parent, hence  an  important  part  of  treatment  lies  in  re- 
moving anything  which  might  interfere  with  the  action 
of  the  pnemogastric,  splenic  and  vasomotor  systems. 
Therefore  raise  the  clavicle,  free  the  muscles  about  the 
neck,  as  well  as  all  other  abnormal  contractures  of  tissues 
along  the  line  down  to  the  sphincter  muscles  at  the  lower 
outlet  of  the  body. 


Applicators  for  Vibratory  Massage  and  Stimulation. 

Stimulation  of  the  spinal  centers  should  begin  at  the 
first  and  second  dorsal  vertebrae  (to  stimulate  the  pulmonary 
plexus)  and  continue  down  the  spine  to  the  tenth  dorsal 
vertebra ;  have  the  arms  stretched  high  above  the  head 
and  bring  arm  down  suddenly  at  each  pressure.  Having 
treated  the  splanchnics  we  turn  the  patient  on  his  back  and 
stimulate  the  liver,1  and  vibrate  every  part  of  the  alimen- 
tary, beginning  at  the  ilio  coecal  valve  and  following  the 
course  of  the  colon ;  repeat  this  several  times,  as  it  tends 
to  restore  normal  capillary  circulation  in  the  relaxed  and 
distended  muscular  fibers.  The  lacteals  are  more  active 
and  absorption  takes  place  more  rapidly  when  the  blood 
12 


178  PRACTICAL    ELECTRO-THERAPEUTICS. 


Diagram  of  Sympathetic  and  Cerebro-Spinal  Systems. 


PRACTICAL   ELECTRO-THERAPEUTICS. 


179 


circulates  quickly  and  freely  through  the  blood-vessels. 
Salol  reaction  has  been  found  in  the  urine  thirty  minutes 
after  taking,  with  massage,  and  in  forty-five  minutes  without 
it,  which  shows  that  massage  hastens  the  food  from  the 
stomach. 

Colic,   pain   in   the   bozvels,   can   frequently   be   relieved 


POS  TEft  OR  BRANCH  OF  SPINAO.  NERVI 


.STERNUM: 
^-**™ 
Application  of  Vibrator  to  Spinal  Nerve. 

instantly  by  bringing  the  body  into  such  a  position  as  to 
stretch  the  region  of  the  splanchnics.  This  may  be  accom- 
plished by  stretching  the  body  backward  over  the  edge  of  a 
table,  or  chair,  and  holding  it  in  this  position  for  a  moment 
or  two.  Stretching  the  right  arm  strongly  upward  while 
pressure  is  being  exerted  on  the  spinal  processes  of  the 
right  side  from  the  fourth  to  the  eighth  dorsal  may  also 


180  PRACTICAL    ELECTRO-THERAPEUTICS. 

give  relief.  The  arms  should  b.e  let  down  quickly  as  point 
of  pressure  is  lowered  on  spine. 

Deep  vibratory  pressure  against  the  splanchnics  inhibits 
them ;  pressure  over  solar  plexus  also  frequently  stops  colic. 

Chronic  Appendicitis. — Our  primary  object  here  is  to  re- 
lieve the  pressure  and  congested  condition  existing  about 
the  lumen  of  the  colon.  It  is  often  a  matter  of  surprise 
to  see  astonishing  results  follow  manual  and  vibratory 
manipulation  when  other  means  have  failed.  Discretion 
and  caution  are  necessary  in  the  treatment  of  these  cases, 
and  relief  may  at  times  be  brought  about  by  gentle,  persis- 
tent, patient  and  thorough  .  manipulation.  Vibrate  entire 
abdomen  gently  to  remove  all  source  of  congestion  until 
toleration  is  obtained ;  relax  all  the  muscles  about  the  riglit 
iliac  fossa,  then  gently  draw  the  -intestines  upward  out 
of  the  iliac  fossa.  These  manipulations,  in  conjunction  with 
colonic  flushing,  frequently  bring  about  complete  cure. 

Hemorrhoids. — In  treating  this  trouble  we  must  bear  in 
mind  the  various  causes  which  might  bring  about  an  ob- 
struction of  the  hemorrhoidal  veins.  The  liver,  spleen, 
colon  and  sigmoid  must  be  considered.  Excessive  irritation 
of  the  sphincter  muscles,  and  pressure  upon  the  inferior 
hemorrhoidal  plexus  of  nerves,  may  produce  them.  In- 
flammation and  congestion  of  adjacent  structures,  may  also 
cause  them  by  interfering  with  the  return  circulation. 
It  is  also  well  to  examine  the  parts  locally  with  an  anointed 
finger  to  see  if  there  is  a  displacement  of  the  coccyx.  If 
this  should  be  the  case,  it  can  be  adjusted  by  grasping  the 
last  two  or  three  sacral  vertebrae  between  the  thumb  and 
first  finger  and  bringing  the  proper  amount  of  pressure  to 
bear  upon  them. 

The  treatment  of  the  hemorrhoids  consists  in  relieving 
the  pent-up  congestion.  This  may  be  accomplished  by 
using  the  flexible  vibratode,  which  should  be  inserted 
while  in  motion,  and  has  taken  the  place  of  the  rectal  bi- 
valve formerly  used  to  divulse  the  sphincters.  The  Penn- 
ington  vibratodes  should  be  used  when  the  local  tenderness 
will  permit  their  use. 

Pressing  on  the  sacral  nerve  desensitizes  them  and 
makes  internal  treatment  less  painful.  This  takes  off  the 
pressure  and  flushes  the  capillaries  and  does  unaccountable 
benefit  in  many  other  ways. 


PRACTICAL   ELECTRO-THERAPEUTICS.  181 

Diarrhea. — Taking  for  granted  that  the  offending  ma- 
terial has  been  removed  from  the  bowel,  our  effort  should 
be  to  allay  irritation. 

The  first  step  in  this  process  is  to  see  that  the  reflexly 
contracted  muscles  about  the  neck  and  along  the  spine  are 
all  relaxed ;  this  may  be  accomplished  eittier  by  means 
of  the  vibrator  or  by  manual  manipulation.  Bending  or 
springing  the  body  backward  and  holding  it  for  a  moment 
will  relax  the  ligaments  in  the  lumbar  region.  Having 
relieved  the  irritation  produced  by  contracted  tissues  about 
the  nerves,  we  proceed  to  inhibit  the  motor  nerves  in  the 
neck  by  holding  them  firmly  for  a  few  minutes.  Deep 
forcible  pressure  in  the  region  of  the  splanchnics  inhibits  the 
excessive  production  of  secretions.  Pressure  below  the 
solar  plexus  along  the  mesenteric  plexus  reverses  persis- 
taltic  movements,  while  pressure  along  the  left  side  of  spine 
from  sacrum  to  the  first  lumbar  also  inhibits.  Pressure 
opposite  the  lower  two  ribs  on  each  side  inhibits  them 
through  the  sympathetic. 

Stimulation  along  bile  duct  increases  flow  of  bile  and 
thus  tends  to  allay  irritation. 

Hernia. — Usually  produced  by  relaxation  of  muscular 
fibers,  due  to  strain.  This  is  a  common  affection  where 
little  is  done  beyond  the  wearing  of  trusses. 

Exercises  which  tend  to  equalize  the  force  of  retention 
will  frequently  restore  the  parts  to  a  normal  condition, 
if  persistently  followed.  Vibratory  treatment  consists  in 
relaxing  the  abdominal  muscles  in  such  a  way  as  to  equalize 
the  tension  of  their  muscular  fibers.  Improvement  in  some 
cases  is  very  rapid,  each  treatment  showing  a  marked  less- 
ening in  the  size  of  the  rent.  Three  treatments  a  week 
are  sufficient. 

Constipation. — In  the  treatment  of  this  trouble  due  re- 
gard must  be  given  to  the  causes  which  have  brought  about 
the  condition.  Experiments  have  shown  that  the  movements 
of  the  intestines  depend  largely  upon  the  amount  of  blood 
in  the  intestinal  walls.  Peristalsis  being  almost  entirely 
a  reflex  action  depends  for  its  existence  upon  the  supply 
of  fresh  blood  which  affects  the  nervous  plexuses  found  in 
the  intestinal  walls.  Anerbach's  plexus  is  found  between 
the  muscular  coats  of  the  intestines  and  is  concerned  with 


182  PRACTICAL   ELECTRO-THERAPEUTICS. 

the  motions  of  the  intestines,  while  Meisner's  plexus,  located 
in  the  submucous  coat  has  to  do  with  the  secretions.  Thus 
we  see  that  anemia  may  be  a  primary  cause  of  constipation. 

2..  Neglect  on  the  part  of  man  to  respond  to  nature's 
suggestion  soon  creates  a  tacit  resignation  on  the  part  of 
the  bowel  to  await  the  convenience  of  the  subject  until  the 
next  day.  Thus  the  habit  duly  cultivated  becomes  a  fixed 
habit.  Consequent  upon  this  retained. effete  matter  a  toxic 
condition  ensues  which  is  usually  designated  as  a  torpid 
liver,  though  in  reality  it  is  an  innocent  but  much-abused 
organ. 

3.  An  insufficient  quantity  of  water  taken  by  the  patient 
is  also  a  frequent  cause.  In  order  to  hold  in  solution  the 
inorganic  substance  and  disorganized  material  so  that  the 
debris  may  be  disintegrated  and  carried  out  in  the  channels 
set  apart  for  this  purpose,  there  must  be  a  sufficient  quan- 
tity of  water  introduced.  One  cup  for  every  ten  pounds 
of  weight  is  the  advice  of  an  eminent  authority. 

The  nerve  supply  of  the  intestines  is  through  the  sym- 
pathetic nervous  system,  from  the  dorsal  vertebra  down. 
To  get  at  the  vasomotor  of  the  mesenteric  vessels  from  the 
splanchnic,  we  must  reach  the  sympathetic  all  the  way  down 
the  spine. 

Stimulation  of  the  pneumogastric  nerve  increases  the 
vermicular  motions  of  the  bowels.  Stimulation  of  the 
vagus  in  the  neck  causes  contraction  of  the  pylorus  and 
stomach  and  produces  a  flow  of  gastric  juice. 

Stimulating  the  splanchnic  arrests  spontaneous  pyloric 
contractions  and  relaxes  the  pylorus. 

Vibratory  treatment  of  the  second,  fourth  and  fifth  lum- 
bar and  fourth  sacral,  which  control  the  splincters,  relaxes 
them  and  thus  frequently  aids  us  to  overcome  con- 
stipation. 

Place  the  patient  on  the  table,  with  knees  elevated,  to 
relax  the  abdominal  muscles.  Then  for  ten  to  fifteen  min- 
utes thoroughly  apply  vibratory  friction,  with  the  multiple 
point  vibratode,  over  the  entire  abdomen,  working  from  the 
umbilicus  as  a  center  outward.  This  greatly  increases  per- 
istalsis and  glandular  activity.  Internal  rectal  vibration 
may  also  be  applied  with  moderate  speed  and  stroke.  The 
sphincters  are  frequently  unduly  sensitive  and  contracted. 


PRACTICAL   ELECTRO-THERAPEUTICS.  183 

The  vibratode  should  be  introduced  into  the  rectum  while  in 
motion  to  avoid  shock. 

This  treatment,  as  a  rule,  causes  complete  relaxation 
and  for  ordinary  purposes  is  as  effective  as  rectal  dilation 
with  the  bivalve,  while  the  shock  to  the  nervous  system  is 
much  less. 

After  applying  the  vibratory  treatment,  reach  down  in 
the  iliac  fossa  and  straighten  out  the  patient's  sigmoid. 

In  using  vibratory  massage  over  the  liver,  be  careful  not 
to  bruise  it. 

Disturbances  in  the  respiratory  tract  practically  all  arise 
as  the  result  of  capillary  congestion  of  the  mucous  and 
submucous  membranes  caused  by  muscular  contractions 
arresting  the  return  of  venous  blood  to  the  heart. 

The  application  of  a  well-recognized  principle  of  physics 
that  heat  relaxes  and  cold  contracts  tissue,  is  largely  respon- 
sible for  many  so-called  colds  in  the  head  and  chest.  This 
condition  usually  appears  shortly  after  the  individual  has 
been  unusually  warm  and  possibly  slightly  moist  about  the 
neck  and  chest.  Exposure  at  this  time  to  a  draft  of  air 
chills  the  parts  and  causes  a  subsequent  contraction  of 
muscular  fibers  which  bind  the  terminal  nerve  filaments  in 
the  upper  dorsal  region.  This  action  results  in  prevention 
of  the  normal  reflexes  to  the  brain  through  the  pneumo- 
gastric  and  sympathetic  nerves  to  the  lungs,  and  in  con- 
tractures  of  the  chest  muscle  that  obstruct  the  return  of 
blood  accumulated  in  the  capillaries  and  intercapillary 
tissues. 

In  all  troubles  of  the  upper  respiratory  tract  we  find 
pressure  upon  the  jugulars,  or  one  or  more  muscles  of 
the  neck  will  be  found  to  have  its  fibers  contracted  either 
on  the  veins  themselves  or  on  the  nerve  supplying  the 
muscle  through  which  it  passes  to  reaqh  the  mucous  mem- 
brane. 

In  affections  of  the  lungs,  the  nerves  accompanying  the 
blood-vessels  are  usually  pressed  upon  by  the  contracted 
muscular  fibers,  making  stasis  in  the  capillaries  inevitable. 

Muscular  contractions  and  consequent  stasis  being  largely 
responsible  for  the  symptoms  present,  the  remedy  suggests 
itself.  Reduce  the  contractions  and  remove  the  irritation 
from  the  sensory  nerve  and  stimulate  the  vasomotor  areas. 


184  PRACTICAL   ELECTRO-THERAPEUTICS. 

Bronchitis. — In  the  treatment  of  respiratory  affections 
general  vibration  of  the  chest  is  indicated  with  special  treat- 
ment for  specific  indications.  In  applying  vibration  to 
the  chest,  raise  the  arms  above  the  head,  thus  elevating  the 
ribs  and  thereby  favoring  chest  expansion  and  relaxation 
of  intercostal  muscles.  In  women,  vibration  to  the  breast 
must  be  avoided.  Use  uninterrupted  vibration  with  fairly 
deep  pressure. 

For  cold  in  the  head  vibrate  sides  of  nose,  ear,  temples, 
forehead,  and  desensitize  the  facial  nerves  at  points  of 
exit  from  foramina;  also  vibrate  glands  of  the  neck  and 
axilla. 

In  applying  vibratory  friction  to  the  chest,  have  the 
patient  breathe  deeply  with  forced  exhalations ;  this  per- 
mits deeper  vibratory  treatment  over  the  deep  structures, 
especially  so  over  the  solar  plexus,  which  should  always 
be  stimulated  as  a  valuable  adjuvant  to  the  other  treat- 
ment. 

Our  treatment  of  the  spine  in  respiratory  affections  is 
given  with  the  intention  of  relaxing  the  spinal  muscles,  to 
give  vent  to  the  pent-up  congestion  and  accumulated  secre- 
tions. Apply  treatment  to  either  side  of  the  spine  from  the 
first  cervical  to  the  seventh  dorsal. 

Stimulation  of  the  vasomotors — the  pneumogastric  and 
phrenic — will  stimulate  the  diaphragm  and  increase  the 
depth  of  respiration,  thus  promoting  absorption  of  oxygen 
and  elimination  of  CO2. 

The  vasomotors  (constrictors)  of  the  blood-vessels  to 
the  lungs  come  from  the  second  to  the  seventh  dorsal 
vertebra. 

Pulmonary  Tuberculosis. — In  most  of  these  cases  we 
find  luxation  of  the  ribs  and  a  flattened  thorax  (dropped 
ribs)  which  set  up  an  irritation  in  the  intercostal  nerves, 
leading  to  a  constriction  of  the  pulmonary  vessels.  The 
general  or  local  anemia  of  lung  tissue  thus  produced  weak- 
ens and  devitalizes  the  tissue,  affording  a  favorable  foothold 
to  the  pathogenic  bacteria,  for  it  is  a  well-known  fact  that 
bacteria  can  not  grow  in  healthy  tissue. 

The  vasomotor  spinal  area  for  the  lung  (second  to 
seventh  dorsal)  and  particularly  the  region  of  the  second, 
third  and  fourth  thoracic  ganglia  are  most  likely  to 


PRACTICAL    ELECTRO-THERAPEUTICS.  185 

suffer  from  lesion  in  this  trouble.  Contractures  of  the 
spinal  muscles  brought  on  by  an  acute  attack  of  rheuma- 
tism or  bronchitis  thus  frequently  prove  to  be  the  starting 
point  of  a  pulmonary  tuberculosis. 

In  applying  treatment  remove  all  obstructions  to  the 
normal  nerve  and  circulatory  activities  and  thoroughly 
relax  the  tissue.  Raise  the  clavicle  and  ribs  to  allow 
the  greatest  area  of  expansion  and  so  increase  the  blood 
supply  to  the  lungs.  The  cough  may  be  relieved  by  ton- 
ing up  the  pneumogastric,  phremic  and  cervical  sympa- 
thetic nerves.  This  is  done  by  treatment  applied  along 
the  trachea  and  anterior  thorax.  Finally  teach  the  patient 
how  to  breathe  correctly. 

Tonsillitis  pharyngitis  and  other  affections  of  the  throat 
may  be  treated  by  stimulation  of  the  superior  cervical 
ganglion ;  vibratory  massage  with  the  bell-shaped  vibra- 
tode  (or  the  operator's  hand,  which  may  be  used  as  a 
vibratode  because  it  permits  the  fingers  to  go  down  between 
the  muscles)  hastens  recovery,  as  it  is  a  great  aid  in  dissipa- 
tion of  the  congested  circulation ;  so  also  is  local  massage 
to  the  fauces.  This  is  accomplished  by  means  of  the  fore- 
finger inserted  in  the  mouth  just  posterior  to  the  last  tooth. 
Press  against  the  posterior  region  of  the  soft  palate,  letting 
the  finger  slide  along  its  border  to  the  opposite  side  and 
back  again. 

Pleurisy. — Stimulate  the  spine  from  the  seventh  to 
the  eighth  dorsal  vertebra.  Raise  the  arm  on  the  affected 
side  as  high  as  possible  to  assist  in  spreading  the  ribs. 
Vibratory  friction  in  the  direction  of  the  lymphatics  and 
contiguous  glands,  supplemented  by  interrupted  vibra- 
tion, will  hasten  the  absorption  of  the  effused  serous 
exudate. 

Asthma  is  generally  the  result  of  reflex  nervous  in- 
fluences and  when  treated  as  such  frequently  gives  im- 
mediate response  to  treatment.  Our  aim  in  treating  these 
cases  is  to  relieve  the  obstructed  nervous  circulation  be- 
tween the  ribs,  the  intercostal  muscles  and  along  the  spine. 
This  is  accomplished  by  deep  vibration  on  either  side  along 
the  entire  spine.  It  not  only  relieves  stasis  in  the  spine, 
but  influences  the  abdominal  plexuses  and  aids  the  circula- 
tion of  venous  blood  and  lymph  in  the  viscera.  Bending 


186  PRACTICAL   ELECTRO-THERAPEUTICS. 

the  body  backward  assists  in  relieving  intervertebral  pres- 
sure, and  by  raising  the  ribs  gives  vent  to  accumulated  se- 
cretions in  the  lungs  and  permits  freer  exhalations  at  once. 

That  one  organ  frequently  thrives  at  the  expense  of 
another  is  nowhere  better  demonstrated  than  in  the  relief 
frequently  obtained  by  patients  suffering  from  asthma, 
when  the  vision  is  repressed  by  the  fogging  method  and 
their  internal  rectus  muscles  rested  by  wearing  prisms,  base 
in.  The  author  has  done  some  pioneer  work  along  this 
line  at  the  bedside  and  has  frequently  seen  instantaneous 
relief  follow  when  the  spasm  was  at  its  worst,  by  the 
simple  application  of  glasses,  the  pulse  frequently  falling 
from  140  per  minute  to  80  per  minute  in  less  than  ten  min- 
utes' time.  The  author's  aim  in  these  cases  was  not  to 
bring  about  perfect  vision,  which  would  have  been  exceed- 
ingly injurious — just  the  contrary  results  were  sought. 

As  the  normal  vision  is  twenty  feet,  anything  inside  of 
this  distance  requires  the  internal  recti  muscles  to  pull 
the  eye  in ;  this,  if  continued  for  hours,  uses  up  an  enormous 
amount  of  energy.  Consider  for  a  moment  the  energy 
expended  in  holding  your  hand  in  a  clenched  or  contracted 
condition  for  a  short  period  of  time  and  the  accompanying 
tension  which  spreads  over  the  entire  body.  A  very  similar 
condition  ensues  when  the  ciliary  muscle  is  focused  upon  a 
near  point  for  hours  at  a  time.  That  this  is  true  is  evidenced 
by  a  lowering  of  the  pulse  of  from  fifteen  to  thirty  beats 
per  minute  by  the  wearing  of  prisms  (base  in)  alone  for 
fifteen  to  twenty  minutes  after  close  eye-work  extending 
over  several  hours. 

Physical  labor  induces  health,  while  occupations  requir- 
ing close  use  of  the  eyes  tend  to  break  it  down.  Strong 
men  leave  country  life  and  take  up  office  calling,  where 
close  range  of  vision  is  required,  and  their  nervous  systems 
usually  break  down.  The  difference  in  the  physical  con- 
dition between  man  and  woman  has  been  attributed  to 
the  fact  that  woman  spends  her  life  indoors  doing  things 
requiring  close  vision,  whereas  the  callings  of  men  afford  a 
longer  range  of  vision. 

The  author's  attention  was  directed  to  this  line  of  in- 
vestigation by  an  oculist,  who  very  much  regretted  that 
the  only  patients  who  consult  this  class  of  specialist  are 


PRACTICAL   ELECTRO-THERAPEUTICS.  187 

those  who  consult  him  because  they  realize  that  their  vision 
is  becoming  defective.  He  believed  that  many  nervous 
troubles  have  their  origin  in  the  loss  of  energy,  dissipated 
by  long  hours  of  close  vision,  and  suggested  that  as  a 
general  practitioner  coming  in  contact  with  a  large  variety 
of  cases  I  would  make  investigations  along  this  line  at 
the  bedside. 

The  results  thus  obtained  have  in  many  cases  been 
startling  and  lead  the  author  to  believe  that  a  large  field 
for  clinical  investigation  is  still  before  us.  The  author  is 
aware  of  the  fact  that  many  wrell-known  specialists  of  nerv- 
ous diseases  claim  there  is  no  such  thing  as  eye  strain. 
Clinical  demonstration  along  this  line,  however,  is  so  easy 
that  no  arguments  are  needed. 

The  why  and  the  wherefore  of  the  relief  thus  obtained 
is  evident  when  we  consider  the  nerve  supply  of  the  eye. 
The  nerve  centers  that  innervate  the  muscles  that  adjust 
the  eye,  in  conjunction  with  -those  in  the  outer  part  of  the 
brain  and  with  that  vast  area  where  vision  itself  takes 
place,  take  up  fully  one-third  if  not  more  of  the  entire  gray 
matter  of  the  brain,  occipital  lobe,  large  part  of  the  parietal 
and  frontal  lobes  of  the  brain,  also  third  and  fourth  ven- 
tricles and  the  aqueduct  of  Sylvius,  deep  in  the  middle  of 
the  brain.  Therefore,  in  resting  the  eye  we  see  that  a 
large  portion  of  the  nervous  system  is  influenced. 

All  diseases  are  emphasized  and  made  worse  by  anything 
that  irritates  and  depletes  the  nervous  system,  and  any 
disease  will  be  relieved  by  the  removal  of  the  energy  rob- 
bing strain.  This  being  the  case,  it  is  well  to  see  to  the  fact 
that  our  patients  suffering  from  nervous  prostration  do 
not  spend  their  entire  time  reading  or  doing  fancy  needle- 
work. It  also  explains  the  benefit  derived  from  sea  voyages, 
where  long  vision  is  the  rule,  and  the  patient  sitting  above 
deck  always  feels  recuperated  from  his.  journey. 

Rheumatism. — In  conjunction  with  drugs,  hot  air,  electric 
light,  baths  and  electricity,  mechanical  vibration  is  a  great 
aid  in  restoring  the  parts  to  their  normal  condition,  as  it 
disintegrates  newly  formed  granulating  tissue,  removes  local 
stasis  and  forces  the  white  corpuscles  and  transuded  plasma 
into  the  lymph  current.  It  increases  nutrition  by  accentuat- 
ing nature's  own  processes  and  thus  stimulates  the  activity 
of  all  the  metabolic  processes. 


188  PRACTICAL   ELECTRO-THERAPEUTICS. 

In  the  treatment  of  this  trouble  it  is  essential  to  stimulate 
the  bowels,  kidneys  and  liver  to  activity,  since  in  the  va- 
rious forms  of  rheumatism  the  digestive  and  circulatory 
system  may  be  deranged  and  the  tissue  fluid  have  under- 
gone pathological  changes. 

In  muscular  rheumatism,  vibratory  stroking  or  rotary 
vibration  should  be  applied,  beginning  superficially  with 
gradually  increasing  pressure,  the  application  in  each  case 
becoming  deep  vibratory  friction.  The  affected  muscles 
should  be  stretched  and  elongated  by  working  against  the 
grain  of  the  muscle  to  throw  more  blood  into  the  parts  and 
thus  help  carry  away  the  diseased  substances. 

In  articular  rheumatism  apply  vibration  with  multiple 
point,  or  rubber-covered  disk,  above  and  below  the  painful 
joint,  gradually  bringing  the  strokes  nearer  and  .nearer 
the  joint  with  increased  pressure.  After  above  treatment 
has  been  applied,  use  interrupted  vibration  to  the  joint 
directly,  beginning  with  very  mild  pressure. 

Spread  the  joints  to  admit  free  access  of  blood  and  nerve 
energy. 

After  time  has  elapsed  for  repair,  use  resistive  motions, 
as  flexion,  extension  and  other  natural  movements. 

Lumbago. — Contractions  and  deviations  in  the  lumbar 
spine  are  the  usual  cause  of  pain  in  this  region.  If  long 
continued,  marked  interference  with  the  vasomotor  and 
trophic  nerves  ensues,  with  lowered  nutrition  in  the  organs 
with  which  they  are  connected.  Frequently  we  find  this 
condition  associated  with  many  distressing  pelvic  disorders. 
Treatment  consists  in  inhibition  and  relaxation  of  con- 
tracted muscles. 

Sciatica. — In  the  treatment  of  this  trouble  it  is  necessary 
to  try  and  locate  the  cause,  if  possible.  The  author's  ex- 
perience leads  him  to  believe  that  a  large  proportion  of 
these  attacks  come  on  consequent  to  acute  indigestion,  colic, 
pain  in  abdomen,  diarrhea,  constipation  and  other  like  dis- 
orders. The  effect  .in  these  cases  being  of  a  reflex  nature, 
transmitted  over  the  solar  plexus,  back  along  the  splanch- 
nics  and  thence  to  the  spinal  nerves  with  which  they  are  con- 
nected ;  thence  back  over  the  peripheral  termination  of 
these  nerves  to  the  skin  and  muscles  of  the  back.  The 
spine  of  most  patients  is  abnormally  rigid  in  these  cases, 


PRACTICAL    ELECTRO-THERAPEUTICS.  189 

though  it  may,  on  the  other  hand,  be  abnormally  mobile 
and  relaxed. 

In  treating  this  trouble  we  should  aim  to  free  the  nerve 
along  its  entire  course  from  contracted  muscle  fibers.  A 
peculiarity  of  the  sciatic  nerve  is  found  in  the  fact  that  it 
is  pierced  by  an  artery  which  supplies  it  with  nutrition. 
Any  contraction  of  the  pyriformis  muscle  is  apt  to  restrict 
the  blood-vessels,  thus  decreasing  its  nutrition.  The  lesion 
may  be  in  the  nature  of  a  strain,  a  congested  muscle  or  a 
tightened  ligament,  thus  drawing  the  vertebrae  together. 
Where  the  lesion  is  undiscoverable,  give  rotary  vibratory 
treatment  to  the  entire  body,  giving  special  attention  to 
the  muscles  of  the  hip  and  upper  portion  of  the  thigh, 
which  should  receive  deeply  interrupted  vibration  over  pain- 
ful spots,  beginning  lightly  and  increasing  as  tolerance 
is  developed  or  pain  lessens  and  disappears ;  continue  gently, 
manipulating  from  side  to  side  to  relieve  the  enlargement 
of  the  vessels,  also  of  any  other  sensitive  area  in  spine. 
Rectal  vibratory  treatments  are  also  of  value,  especially  in 
those  cases  due  to  fecal  impaction.  Vibration  to  the  liver 
and  spleen  anteriorly  is  also  indicated.  Treat  the  spine  on 
either  side  from  the  sixth  dorsal  down  to  the  fifth  lumbar. 
The  operator  will  also  find  that  rotating  the  limb  outwards 
tends  to  relax  the  muscles  throughout  the  whole  course  of 
the  nerve,  while  turning  the  leg  inward  relaxes  the  pyrifor- 
mis and  those  short  muscles — the  external  rotators — which 
may  impinge  upon  the  nerve.  The  sciatic  nerve  may  be 
stretched  by  raising  the  limb  up  as  far  as  possible,  keeping 
knee  straight  and  pulling  down  on  toes.  This  treatment 
tends  to  loosen  the  dorsal  as  well  as  the  lumbar  muscles. 

Mental  disorders  are  often  relieved  when  vibratory  stimu- 
lation is  applied  according  to  indications ;  spinal  and  local 
sensitive  areas  indicate  contractions  which  should  be  relaxed. 

Headaches  associated  with  gastric  derangement  are  fre- 
quently relieved  when  all  the  muscles  about  the  neck  have 
been  relaxed.  Raise  the  clavical  and  stimulate  the  liver, 
stomach  and  bowels  and  inhibit  the  superior  cervical  ganglia  ; 
vibratory  stroking  should  be  applied  to  the  forehead,  sides 
of  the  face  and  especially  all  branches  of  the  fifth  nerve. 
Pressure  on  basi-occipnt  will  limit  the  flow  of  blood  to  the 
brain  and  thus  bring  about  relief. 


190  PRACTICAL    ELECTRO-THERAPEUTICS. 

Neuralgia. — Remove  all  pressure  from  the  nerve,  or 
nerves,  involved  in  the  production  of  pain.  Always  treat  the 
parts  high  enough  to  reach  the  impingement  of  the  nerves 
involved.  Pain,  as  a  rule,  does  not  originate  where  we  feel 
it ;  it  is  usually  the  end  nerves  where  the  pain  is  felt.  Stimu- 
late the  center  in  the  spinal  cord  from  which  the  affected 
nerve  is  given  off. 

Occupation  Neurosis. — All  the  numerous  occupation  neu- 
roses, such  as  those  of  musicians,  telegraphers,  seamstresses, 
barbers,  drivers,  milkers,  cigar  makers,  penmen,  etc.,  are  in 
reality  starvation  neurosis  and  manifestations  of  a  more  or 
less  severe  obstruction  of  nerve  supply.  The  occupation 
which  brings  about  these  conditions  usually  requires  the  ele- 
vation of  the  right  shoulder,  resulting  in  drawing  the  upper 
ribs  together  and  approximating  the  clavicle  and  first  rib 
in  such  a  manner  as  to  bring  pressure  to  bear  upon  the 
brachial  plexus.  Treatment  consists  in  stimulating  the  cer- 
vical ganglia  and  brachial  area.  Thoroughly  vibrate  the  up- 
per shoulder,  neck,  back  and  chest ;  raise  clavical,  ribs,  etc. 
Change  faulty  position  of  holding  pen,  brush  or  other  imple- 
ment of  occupation. 

Insomnia  is  always  due  to  perverted  cerebral  circulation 
which  causes  certain  cells  to  be  unduly  irritated.  Treatment 
consists  in  thoroughly  relaxing  the  muscles  of  the  neck  to 
relieve  cereb'ral  congestion  and  finally  inhibition  of  the 
superior  cervical  ganglia ;  through  its  connection  with  the 
medulla  we  influence  the  general  circulation  of  the  body,  in 
that  it  affects  the  vasomotor  centers  in  the  medulla. 

Chorea. — Vibratory  stimulation  of  the  spinal  centers  and 
abdominal  organs  is  of  great  aid  in  the  treatment  of  this 
trouble. 

Hysteria. — Where  due  to  a  nutritional  disorder  of  the 
nervous  system,  great  relief  is  often  obtained  by  vibratory 
stimulation  applied  to  the  spine.  Relaxation  of  the  con- 
tracted fibers  of  the  sphincter  ani  by  means  of  the  rectal 
vibratode  is  at  times  followed  by  marked  improvement. 

Locomotor  Ataxia. — Treatment  consists  in  thoroughly 
freeing  all  parts  from  pressure,  special  attention  being 
directed  to  the  parts  obstructed  on  the  structures  involved. 
The  only  way  to  reach  these  lesions  is  reflexly  through  the 
sympathetic  nerves.  The  great  trunks  coming  out  of  the 


PRACTICAL   ELECTRO-THERAPEUTICS.  191 

skull,  namely  the  spinal  accessory,  the  pneumogastric  and 
the  cervical  ganglia  on  both  sides  of  the  neck  and  clear 
down  the  spinal  column  receive  special  attention.  Stimulate 
the  flow  of  blood  from  one  end  of  the  spine  to  the  other. 
Give  attention  to  local  symptoms  according  to  their  na- 
ture. 

Hemiplegia  indicates  that  something  has  interfered  with 
the  nerve  and  blood  supply  to  the  limb,  and  our  efforts 
should  be  directed  to  restoring  the  parts  to  their  normal 
condition,  relaxing  all  contracted  tissue  and  using  vibratory 
stimulation  of  center  in  spine  and  stroking  to  the  limb  in- 
volved. Put  the  leg  through  the  various  motions  which  tend 
to  free  the  blood  supply.  Flexing  the  leg  on  the  thighs 
bent  on  the  adbomen  stretches  the  quadriceps  extensor  muscle 
and  frees  the  femoral  artery,  anterior  veins  and  anterior 
crural  nerve.  Pushing  the  toes  down  or  up  exercises  and 
places  both  anterior  and  posterior  muscles  of  the  thigh  on  a 
stretch.  Frequently  it  is  important  to  stretch  these  muscles. 
Relax  all  tissue  about  Scarpas  triangle  as  well  as  those  in 
the  popliteal  space ;  in  fact,  remove  rigidity  wherever  found, 
especially  in  the  region  of  the  spine. 

Varicose  Veins. — The  nerves,  blood  supply,  the  lymphatics 
and  glandular  supply  of  the  entire  leg  should  receive  vibra- 
tory friction  to  carry  off  the  detritus  left  along  the  course 
of  the  diseased  vessels  and  around  the  ulcer.  Treat  the 
sciatic  nerve  with  the  view  of  contracting  the  muscles  and 
forcing  the  blood  from  the  site  of  its  engorgement  and  so 
temporarily  relieve  the  congestion.  The  sciatic  nerve  ex- 
ercises a  marked  influence  on  the  vessels,  as  well  as  on  the 
muscles  of  the  leg;  its  origin  in  the  spine  should  therefore 
receive  special  attention.  Marked  sensitiveness  is  fre- 
quently found  over  the  splanchnic  area,  the  result  of  a  weak- 
ened condition  of  the  vasomotor  nerves  in  this  area.  Treat 
the  entire  spine  in  these  cases,  giving  especial  attention  to 
the  fifth  lumbar  vertebra. 

Abscesses. — Interrupted  vibration  applied  to  the  glands 
and  lymphatics  contiguous  to  the  affected  area  hastens  the 
elimination  of  waste  and  toxic  materials.  The  liver,  spleen 
and  kidneys  should  also  be  freely  stimulated. 

Urethritis. — Stimulation  of  the  vasomotor  area  of  the 
affected  parts  will  bring  about  a  more  efficient  blood  flow, 


192  PRACTICAL    ELECTRO-THERAPEUTICS. 

thus  aiding  in  the  destruction  of  the  invading  microbe. 
Stimulation  of  the  glands  and  lymphatics  draining  the  af- 
fected parts  increases  their  activity  and  hastens  the  elimi- 
nation of  the  toxines  caused  by  the  microbe. 

Bubo,  following  Urcthritis. — Treat  lymphatics  as  above 
and  stimulate  eighth  and  twelfth  dorsal  and  fifth  lumbar 
spinal  nerves. 

Acute  Sprain  or  Fracture. — Vibratory  friction  to  the  swol- 
len parts  usually  gives  great  relief  from  pain,  diminishes 
the  swelling,  shortens  the  period  of  repair,  favorably  affects 
absorption  and  circulation  and  prevents  stiffness.  Under 
the  author's  manipulation  it  gave  the  greatest  amount  of 
comfort  imaginable  to  an  elderly  gentleman  suffering  from 
a  fractured  femur  which  was  being  treated  by  extention. 
The  relief  from  pain  following  vibratory  friction  was  greater 
than  that  following  the  administering  of  an  opiate. 

Goiter. — Vibrate  and  thoroughly  relax  all  contracted 
muscles  about  the  neck  and  desensitize  all  sensitive  points  in 
the  cervical  and  dorsal  regions,  using  deep,  firm  pressure. 
Next  thoroughly  vibrate  the  lymphatics  with  the  multiple 
point  or  rubber-covered  disk  vibratode.  Stimulation  of  liver 
and  spleen  is  also  indicated.  Stimulate  the  vasomotor  area 
in  spine  to  re-establish  nerve  connection  between  the  sympa- 
thetic and  motor  nerves  and  thus  start  the  fluids  out.  Raise 
the  clavicle  and  manipulate  the  gland  upward,  kneading  the 
gland. 

Fever. — Vibratory  friction  with  moderate  stroke  and 
pressure,  applied  from  the  beginning,  in  fevers,  is  found 
to  be  a  great  aid  in  hastening  the  patient's  recovery.  The 
impulse  and  friction  accelerate  the  flow  of  lymph  through 
the  tissues,  while  the  stimulation  of  the  peripheral  circula- 
tion prevents  fatigue,  general  irritability,  cerebral  conges- 
tion and  keeps  the  patient  mentally  brighter. 

The  glands  of  the  body  should  receive  deep  interrupted 
vibration,-  while  the  various  spinal  centers  should  also  be 
treated. 

Pelvic  Diseases. — The  pelvic  organs  are  so  located  that 
weakness  or  prolapse  of  the  abdominal  organs,  intestines, 
stomach,  kidneys  and  liver  in  particular  can  readily  interfere 
with  their  health.  Hence  in  the  treatment  of  pelvic  troubles 
particular  attention  should  be  paid  to  the  correction  of  the 


PRACTICAL   ELECTRO-THERAPEUTICS.  193 

abdominal  condition ;  when  accomplished,  the  pelvic  disturb- 
ances will  frequently  right  themselves.  Apply  treatment 
over  the  parts  anteriorly  as  well  as  through  the  proper  spinal 
connections.  Look  up 'nerve  connections. 

The  uterus  and  ovary  may  be  affected  in  much  the  same 
manner  as  other  parts  of  the  body.  We  find  these  organs 
suffering  from  faulty  innervation  or  blood  supply.  We 
can  often  trace  disturbances  of  menstruation,  inflammation, 
etc.,  to  an  impinged  or  irritated  spinal  nerve  supply.  Oc- 
casionally an  incipient  curvature  of  the  lumbar  or  lower 
dorsal  spine  will  be  found,  which  in  many  cases  is  undoubt- 
edly the  cause  of  the  so-called  reflex  pains  in  the  back  and 
thighs. 

Menopause. — Deep  vibratory  friction  with  the  multiple 
point,  or  rubber  disk,  accelerates  the  flow  of  blood  and  tends 
to  lessen  the  heat  of  the  interior  of  the  body.  Interrupted 
vibration,  with  moderate  pressure  applied  to  the  solar 
plexus  and  umbilicus,  has  a  marked  effect  in  equalizing  the 
circulation  and  ameliorating  the  various  symptoms  com- 
plained of  during  the  period.  If  the  treatment  is  too  pro- 
longed we  lose  the  effect  of  the  treatment. 

Enuresis. — Relax  and  stimulate  over  the  middle  lum- 
bar vertebra,  as  well  as  the  second,  third  and  fourth 
sacral. 

Spinal  Curvature. — The  curvature  in  a  large  number  of 
cases  is  caused  by  an  abnormal  muscular  contraction  on 
the  concave  side,  due  to  a  primary  irritation  of  nerve  fila- 
ments ending  in  that  part. 

In  treating  this  condition  we  must  take  into  consideration 
the  fact  that  the  vertebrae  may  have  changed  in  form 
and  become  flattened  on  one  side,  and  the  vertebrae,  even 
when  replaced,  are  bound  to  return  to  their  abnormal 
positions  unless  the  ligaments  which  hold  them  in  place 
are  strengthened  by  a  proper  amount  of  nourishment 
or  blood  and  nerve  supply. 

Vibratory  treatment  will  greatly  augment  orthopedic 
measures,  such  as  tension  or  traction  on  the  vertebrae  in- 
tended to  separate  the  vertebrae  to  allow  free  ingress  of 
blood.  In  fact,  mild  cases  may  be  cured  by  vibratory 
measures  alone. 

Thoroughly  relax  the  muscles  on  the  concave  side  and 

13 


194  PRACTICAL    ELECTRO-THERAPEUTICS. 

stimulate  the  already  relaxed  muscles  on  the  convex  side. 
Begin  treatment  at  the  bottom  of  the  curvature  and  work 
up;  the  lower  vertebrae  are  larger  than  those  above  and 
therefore  more  stable. 

Attempt  to  replace  one  vertebra  at  a  time.  There  is  dan- 
ger of  producing  an  inflammation  of  the  psoas  muscle  if 
the  treatments  are  too  harsh  or  too  severe  at  the  eleventh 
and  twelfth  dorsals  and  the  first  and  second  lumbar 
vertebrae.  The  muscles  at  this  point  are  easily  irritated. 

Hepatic  Insufficiency. — Irritation  of  the  liver  .is  frequently 
reflected  to  the  right  intercostal  muscles,  causing  them 
to  contract.  If  this  is  the  case  it  will  be  found  that  the 
ligaments  and  muscles  at  the  spinal  attachment  of  the  in- 
volved ribs  are  very  sensitive  to  deep  pressure.  If  con- 
tinued for  any  length  of  time  the  muscles  subjected  to  irrita- 
tion contract  and  draw  the  body  toward  the  affected  side, 
the  circulation  within  the  cord  throughout  the  irritated 
area  becomes  more  or  less  compromised  and  a  lowered 
nutrition  of  both  nervous  and  muscular  elements  speedily 
follows.  Treatment  consists  in  relaxing  the  contracted 
intercostal  and  spinal  muscles.  This  is  usually  accomplished 
by  using  vibratory  friction  with  long  stroke  and  deep  pres- 
sure applied  thoroughly  over  the  ribs.  Treatment  may 
require  from  one  to  three  minutes.  Treat  the  liver  ante- 
riorly, being  careful  not  to  bruise  it.  Abdominal  treatment 
should  be  directed  especially  to  the  hepatic  and  sigmoid 
flexure.  Repeat  treatment  on  alternate  days  until  ribs  are 
replaced  and  spine  is  straightened. 

Diabetes. — Remember  its  mental  origin  and  stimulate  the 
liver  and  kidneys  thoroughly.. 

Convalescence  from  exhausting  disease  is  greatly  assisted 
by  proper  vibratory  spinal  treatment,  as  well  as  by  vibra- 
tory stimulation  of  the  entire  glandular  system. 

Ear. — Impaired  hearing  due  to  cold,  full  feeling  in  the 
ears,  otalgia,  tinnitus,  nervous  deafness,  non-suppurating 
inflammation  of  the  auditory  tract,  and  suppurative  otitis 
after  the  suppuration  has  ceased,  are  successfully  treated 
by  mechanical  vibration. 

To  affect  the  vasomotor  of  the  head  we  vibrate  the  su- 
perior cervical  ganglia. 

The  superior  cervical  ganglion  may  be  reached  directly 


PRACTICAL   ELECTRO-THERAPEUTICS.  195 

by  applying  pressure  at  the  upper  part  of  the  anterior 
border  of  the  sterno-cleido-mastoid  muscle  in  front  of  the 
transverse  processes.  It  may  also  be  reached  indirectly 
through  the  spinal  connection  at  the  upper  cervical  verte- 
brae. 

Vibratory  friction,  or  massage,  of  all  tissues  surrounding 
the  ear  and  neck  increases  the  circulation  through  the  dor- 
mant lymph  and  blood-vessels  and  thus  hastens  the  absorp- 
tion of  the  products  of  inflammation,  stimulates  the  secre- 
tions, restores  muscular  tone  and  strengthens  the  exhausted 
nerves. 

In  treating  the  tissues  surrounding  the  ear,  always  use 
the  soft  rubber  or  cup-shaped  vibratode.  In  acute  disor- 
ders daily  treatments  are  required,  while  in  chronic  con- 
ditions treatment  every  other  day  is  the  rule. 

Eye. — Affections  of  the  eye,  not  due  to  the  presence  of 
a  foreign  body,  may  be  favorably  influenced  by  mechanical 
vibration.  Thoroughly  relax  everything  and  remove  every 
pressure  which  may  affect  the  circulation.  As  the  fifth 
nerve  contains  some  trophic  fibers  of  the  anterior  eye 
and  has  a  vasomotor  effect  on  the  retina,  it  is  important 
to  see  that  this  nerve  is  free  from  contractions  in  the  supra- 
orbital,  infraorbital  or  mental  foramina. 

The  cervical  region  is  in  close  connection  with  the  muscu- 
lar action  of  the  eye,  and  it  is  here  that  treatment  should 
be  applied  when  the  cause  of  the  trouble  is  due  to  eye-strain. 
The  superior  cervical  ganglion,  which  through  the  carotid 
and  cavernous  plexus  is  distributed  to  the  parts  surround- 
ing the  eye,  should  also  be  stimulated  or  inhibited  as  the 
conditions  may  indicate. 

The  spinal  nerves  should  be  treated  as  low  down  as  the 
fifth  dorsal,  mainly  for  the  nutritional  effect. 

The  ciliary  ganglia  lying  at  the  bottom  of  the  orbit  be- 
tween the  rectus  muscle  and  the  optic  nerve  may  be  stim- 
ulated by  slight  pressure  anteriorly  applied  by  means  of 
eye  attachment. . 


196 


PRACTICAL    ELECTRO-THERAPEUTICS. 


C.,  Cervical.    L.,  Lumbar.    D.,  Dorsal.    S..  Sacral. 


Arteries  

Circulation    influenced  by    stimula- 
tion or  inhibition  at  

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Face  

Cervical  brain     .  .                       

1 

7 
9 

Abdominal  brain  

Pelvic  brain  

Vaso-dilators  

Vaso-constrictors  

Recti  of  eyeball 

Esophagus  

Vaso-dilator  of  ant.  part  of  eye  

Treat  between  

Catarrh 

Nutrition  center  

6 

Larynx  

Heart  

Rythm  j 

Lungs  

Diaphragm  

Hiccough  inhibit 

3 

Liver  

Treat  at                     

And  gall-bladder.  
Torpid  on  rt.  side 

and 

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1 
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Defecation  center  

6 

Urethra 

Bladder 

Testes.               

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j    Spermatic  center  

Prostate  gland  

1    Erection  center  

5 

L. 

9 

to 

to 

Ovaries  
Uterus  

Circulation  controlled  
Pain  

1 

L. 

to 

Os     .  .           

1 
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1  L. 
12D 

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Amenorrhea  stimulate 

Morning  sickness  stimulate 
To  relax  

Paralysis  

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Upper  extremity  

Vaso-motors  

fron 

LIGHT. 

It  has  long  been  known  that  impure  air  and  darkness  breed 
disease,  but  it  is  only  recently  that  we  have  learned  why  and 
how  light  exercises  its  power.  Investigation  has  demon- 
strated that  it  is  not  warmth  but  light  which  enables  more 
complicated  tissues  to  be  formed  from  simple  ones.  The 
importance  of  light  on  living  organisms,  plants  and  animals 


Genuine  Finsen  Light. 

alike,  is  well  known  to  all.  Lack  of  light  causes  disease  and 
vice  versa.  We  find  the  least  illness  and  the  most  healthy 
conditions  in  places  to  which  light  has  most  ready  access. 

The  existence  of  three  different  kinds  of  rays  has  been 
clearly  demonstrated,  and  it  is  possible  that  others  exist. 

1.  Heat  rays  (four  hundred  and  ninety-seven  billion  vibra- 
tions per  second),  found  near  the  red  end  of  the  spectrum, 
are  for  the  most  part  invisible  and  do  not  impress  the  eye,  but 
powerfully  impress  the  nerves  of  the  skin. 

197 


198  PRACTICAL    ELECTRO-THERAPEUTICS. 

2.  Chemical  rays  (seven  hundred  and  twenty-eight  billion 
vibrations  per  second) — violet  and  ultra-violet — make  slight 
impression  on  the  eye,  but  stimulate  the  skin  in  a  remarkable 
manner,  cause  sunburn  and  bring  about  chemical  changes 
or  combinations  in  the  tissues.      The   sun's   rays  have  no 
chemical  quality  in  and  of  themselves,  their  action  depending 
upon  the  surface  upon  which  the  rays  strike.      The  germ- 
destroying  power  of  light  is  equal  to  the  sum  of  its  vibratory 
forces.     It  is  these  rays  that  make  it  possible  to  photograph 
smallpox  and  measles  before  they  become  visible  to  the  eye. 
Ultra-violet  frequencies  are    made  visible   by   their    action 
upon  fluorescent  substances  (the  ability  of  certain  substances 
to  absorb  energy  of  radiation  at  one  length  and  to  emit  it  at 
another). 

3.  The  luminous  rays  are  centered  near  the  yellow  portion 
of  the  spectrum  and  are  those  which  powerfully  impress  the 
optic  nerve. 

That  light  exercises  a  powerful  influence  over  plant  and 
animal  life  is  well  known.  Plant  growth  seems  to  depend 
on  the  luminous  rays,  flowering  on  the  ultra-violet  and  the 
aroma  on  the  heat  rays. 

The  turning  of  flowers,  leaves  and  even  stems  toward  the 
sun  conclusively  proves  the  influence  of  light  upon  vegetable 
organisms.  Continuous  exposure,  however,  proves  injurious 
to  plants,  which  require  rest  from  sunlight  as  do  animals. 
Plants  exposed  to  the  direct  rays  of  the  arc  light  wither, 
the  interposition  of  glass,  however,  has  the  same  effect  as 
the  atmosphere  has  on  the  sun  rays.  This  action  is  readily 
demonstrated  by  placing  a  green  leaf  under  an  arc  light, 
protecting  one  half  with  glass.  The  unprotected  part  will 
turn  brown,  while  the  other  will  remain  green. 

Experiments  show  that  electric  light,  properly  employed, 
compares  favorably  with  sunlight  in  its  power  to  promote 
protoplasmic  activity  and  to  inhibit  the  action  of  bacteria. 
It  acts  as  a  tonic  to  plants  and  enables  them  to  endure  adverse 
conditions  which  they  would  not  otherwise  resist. 

A  very  important  character  of  light  in  connection  with  its 
use  for  curative  power  is  its  power  of  destroying  bacteria. 
Various  animals  have  been  inoculated  with  diphtheria  and 
other  germs.  Those  animals  kept  in  the  dark  died  in  from 
two  to  three  days;  those  exposed  to  the  rays  of  light  resisted 
the  effects  of  the  inoculation.  Many  forms  of  germs  are 


PRACTICAL    ELECTRO-THERAPEUTICS.  199 

killed    more    readily    by  sunlight    than    by    strong    germi- 
cides. 

The  chemical  or  so-called  actino-therapeutic  rays  can  only 
be  obtained  from  the  sun  or  the  electric  arc  light.       The 


Triplet  Lamp.    Scholtz's  Modification  of  the  Finsen. 

spectrum  of  sunlight  taken  in  high  altitudes  shows  it  to  be 
rich  in  the  ultra-violet  rays,  but  on  account  of  atmospheric 
absorption  few  reach  the  earth.  This  is  especially  true  of  the 
sunlight  near  towns  and  cities  where  the  chemical  rays  are 
strong  enough  to  affect  the  photographic  film,  but  not  strong 


200  PRACTICAL    ELECTRO-THERAPEUTICS. 

enough  for  bleaching  and  chemical  purposes.  The  spectrum 
from  an  electric  arc  taken  through  quartz  shows  it  to  be  six 
to  eight  times  as  long  as  the  visible  spectrum.  The 
incandescent  bulb  light  has  little  actinic  power  and  penetra- 
tion. An  increase  in  candle-power  or  number  of  lights  will 
not  give  any  practical  increase  in  actinic  power,  comparable 
to  even  the  smallest  arc. 

To  Finsen  the  profession  owes  much  for  the  thorough  and 


The  Finsen  Lamp.     London  Hospital  Pattern 

scientific  manner  in  which  he  has  demonstrated  the  action  of 
the  chemical  rays  alone,  and  their  usefulness  in  skin  affec- 
tions, especially  those  of  a  tubercular  nature.  His  experi- 
ments show  that  the  bactericidal  effects  of  sunlight  are  found 
in  the  ultra-violet  or  chemical  rays.  He  succeeded  in  sepa- 


PRACTICAL    ELECTRO-THERAPEUTICS. 


201 


rating  the  chemical  from  the  heat  rays  by  filtering  sunlight, 
focused  through  quartz  lenses,  through  a  blue  solution  of 
copper  sulphate  in  a  dilute  ammonia  water,  varying  the 
strength  of  the  solution  to  suit  the  intensity  of  sun's  rays 
at  the  different  seasons. 


The  "Dermo"  Finsen  Arc  Light. 

During  the  summer  months  Finsen  uses  glass  lenses.  As 
some  ultra-violet  rays  pass  through  all  glass,  the  deficient 
permeability  of  the  collecting  lens  is  compensated  for  by 
large  size,  thus  making  it  equal  in  actinic  power  to  a  smaller 
rock  crystal  lens. 

As  sunlight  is  necessarily  limited  during  the  winter  months, 
Finsen  uses  large  arc  lights  of  sixty  to  eighty  amperes,  each 
light  having  four  condenser  tubes,  dividing  the  light  so  as  to 

}  i.L  l£  ^  i" 


202 


PRACTICAL   ELECTRO-THERAPEUTICS. 


treat  four  patients  at  once.  The  tissues  outside  of  the  lesion 
are  protected  from  the  rays.  A  nurse  wearing  dark  glasses 
presses  the  compressor  on  the  spot  to  be  treated. 

The  tissues  treated  are  compressed  to  empty  the  blood- 
vessels, as  opacity  of  tissue  is  due  principally  to  red  blood 
corpuscles.  Compression  is  accomplished  by  a  hollow 
crystal  disk,  which  is  cooled  by  a  constant  stream  of  cold 
water  passing  through  it. 


Application  of  Lupus  Lamp. 

The  spectrum  of  a  lightning  discharge  shows  it  to  have 
a  large  number  of  chemical  rays.  This  being  the  case,  the 
spark  from  the  static  machine  or  induction  coil  may  be  made 
use  of  in  the  treatment  of  small  superficial  ulcers,  syphilitic 
or  otherwise.  The  apparatus  made  for  use  with  the  static 
machine  consists  of  five  aluminum  balls  insulated  on  hard 
rubber  tips,  arranged  in  the  form  of  a  letter  S  along  which 
the  spark  flashes  from  ball  to  ball.  A  quartz  disc  serves 


PRACTICAL    ELECTRO-THERAPEUTICS.  £03 

as  a  cap,  and  permits  it  to  be  brought  in  contact  with  tissues 
treated. 

Various  modifications  of  the  Finsen  lamp  are  now  on  the 
market.  One  of  them  is  made  with  hollow  iron  electrodes, 
which  are  kept  cool  by  the  constant  circulation  of  water. 
The  beam  of  white  light  is  cold.  It  is  claimed  for  the  iron 
electrodes  that  they  are  richer  in  chemical  rays  than  the 
carbon,  though  carbon  electrodes  containing  a  large  amount 
of  iron  and  manganese  also  give  a  markedly  violet  flame. 

The  treatment  usually  lasts  from  one  to  one  and  a  half 
hours,  and  is  repeated  until  the  parts  are  cicatrized.  The 
area  treated  is  usually  one  to  three  square  centimeters. 

There  is  no  pain  during  the  application;  sometimes  there 
is  an  itching  and  the  surface  reddens.  A  few  hours  later 
a  vesicle  filled  with  clear  serum  appears  and  dries  in  a  few 
days,  leaving  a  thin  crust.  Sloughing  never  occurs.  The 
effect  is  simply  that  of  an  intense  sunburn.  Cure  is  not 
due  to  the  destruction  of  tissue,  but  to  the  destruction  of 
parasitic  elements  upon  which  the  disease  depends,  and  a 
quickening  of  vital  activities  of  tissues,  whereby  their  power 
of  defense  is  increased. 

The  action  of  the  light  ray  is  a  complicated  one;  aside 
from  its  bactericidal  powers  it  influences  the  vaso-motor 
nerves  and  affects  capillary  dilatation.  If  the  action  of  the 
light  is  continued  for  a  length  of  time  it  causes  a  distinct 
endo-vasculitis,  followed  in  time  by  a  low  grade  of  inflamma- 
tion and  consequent  permanent  atrophy  of  the  vascular  tissue. 

With  an  arc  light  of  two  to  ten  amperes  only  superficial 
dermatoses  can  be  reached.  A  fifty  to  eighty  ampere  lamp 
will  influence  a  photographic  plate  through  the  thickness  of 
the  human  body.  Investigators  have  not  yet  decided  as  to 
whether  this  property  can  be  successfully  employed  in -the 
treatment  of  diseases  of  internal  organs.  Several  experi- 
menters using  fifty  to  eighty  ampere  lights  report  cures 
of  various  cases  of  carcinoma  of  the  skin,  epithelioma,  rodent 
ulcer  and  Paget's  disease,  the  result  being  equal  to  those 
obtained  by  X-rays. 

The  effects  from  the  light  treatment,  being  immediate,  are 
controllable,  which  is  a  decided  advantage  over  the  X-rays, 
where  the  effect  is  only  visible  after  a  number  of  days  or 
even  a  week  or  more. 

In  Lupus  vulgaris,  tubercular  verrucosa  cutis,  tubercular 


204 


PRACTICAL    ELECTRO-THERAPEUTICS. 


ulcer,  etc.,  the  Finsen  light  treatment  has  been  found  to  be 
the  most  effective  and  innocuous  treatment.  Finsen  reports 
over  one  thousand  cases,  mostly  cured,  and  has  arrived  at 
the  conclusion  that  lesions  which  do  not  react  under  its  use 
are  not  tubercular.  Lupus  erythematosus  also  responds  to 
this  treatment  with  about  thirty-three  per  cent,  of  cures. 

Alopecia  areata,  when  due  to  a  parasitic  disease,  has  also 
responded  to  this  form  of  treatment. 

Actino  therapy  has  also  been  employed  in  various  forms 
of  birthmark,  naevus,  etc.  The  endo-vasculitis  excited  by 
the  light  finally  leads  to  cicatricial  contractions  and  oblitera- 
tion of  the  redundant  vessels. 


The  Helios  Therapeutic  Arc  Lamp. 


BLUE  LIGHT  TREATMENT. 

Professor  Minin  of  St.  Petersburg  first  called  attention 
to  the  therapeutic  uses  of  the  blue  incandescent  light  globe 
(in  place  of  arc  light  filtered  through  a  blue  solution).  These 
rays  have  a  peculiar  effect  on  the  vaso-motor  nerves,  caus- 
ing a  constriction  of  the  blood  vessels  in  the  tissues  exposed. 
A  marked  anemia  is  thus  produced  which  frequently  has  a 
surprising  pain-calming  influence.  Thus  the  pains  of 


Multiple  Minin  Lamp. 

pleurisy,  cutaneous  inflammations  and  contusions  promptly 
disappear,  permitting  a  more  thorough  examination.  Pro- 
fessor Minin  even  reports  making  painless  incisions  and 
stitches  without  the  use  of  cocaine. 

The  constriction  of  the  superficial  blood-vessels  rapidly 
causes  the  absorption  of  infiltration  about  the  edges  of  ulcers, 
and  gives  the  impression  that  the  ulcer  is  leveling  itself  and 
becoming  smaller  during  each  exposure.  The  ulceration 

205 


20G 


PRACTICAL    ELECTRO-THERAPEUTICS. 


is  covered  with  a  very  thin  membrane  and  becomes  smaller. 
The  edges  of  the  ulcer  are  soon  covered  with  skin  of  normal 
color  and  elasticity,  and  as  these  edges  come  nearer  and 
nearer  to  each  other,  complete  restitution  of  tissue  soon  takes 
place.  Cicatrization  does  not  pass  through  those  phases 
ordinarily  observed,  because  there  is  no  development  of 
connective  tissue. 

It  goes  without  saying  that  in  specific  ulcerations  the 
microbes  which  occasion  them  perish  in  the  first  place,  and 
then  only  does  the  restitution  of  the  ulcerated  tissues  com- 
mence. 


Stand  and  Reflector  for  Minin's  Ultra-Violet  Light. 

The  author  has  seen  a  severely  infiltrated  foot  denuded  ot 
skin  from  the  ankle  down,  following  a  severe  infection, 
become  covered  with  the  fine  membrane  above  spoken  of  dur- 
ing the  first  exposure,  which  marked  the  beginning  of  a  cure 
that  took  place  in  about  six  weeks.  The  condition  had  lasted 
over  eight  months,  during  which  period  the  patient  was  in 
a  hospital,  from  which  he  was  discharged  because  he  was 
unwilling  to  undergo  an  operation,  or  a  number  of  operations, 


PRACTICAL    ELECTRO-THERAPEUTICS.  207 

for  skin  grafting,  which  the  hospital  staff  had  decided  were 
necessary  to  bring  about  a  cure. 

The  infiltrated,  bleeding  edges  and  surfaces  of  malignant 
growths  are  rendered  anemic,  which  frequently  prevents 
the  recurrent  hemorrhages  and  relieves  the  pain  in  surround- 
ing tissues.  It  thus  accelerates  the  cure  of  such  cases  as 
are  being  treated  by  the  X-ray.  The  secretions  so  fetid 
and  plentiful  in  malignant  growths  are  checked  to  a  marked 
degree  by  a  long  daily  exposure.  The  parts  surrounding 
the  sore  may  be  protected  against  prolonged  action  of  the 
light.  The  effect  of  this  light  is  to  deplete  the  granulating 
surface  of  its  blood,  thus  preventing  tissue  activity. 

Bearing  in  mind  the  physical  properties  of  this  light,  we 
find  a  wide  field  of  usefulness  for  its  absorptive,  antiseptic 
and  anesthetic  powers,  and  its  portability  permits  its  use 
even  by  bedridden  patients. 

In  phymosis  due  to  chancre  of  recent  origin  the  foreskin 
can  frequently  be  retracted  after  five  to  ten  minutes'  expo- 
sure. 

'  In  orchitis  the  pain  and  swelling  are  greatly  diminished 
after  ten  to  twenty  minutes'  exposure.  The  swelling  about 
an  infected  area  usually  diminishes  in  about  fifteen  to  thirty 
minutes,  to  disappear  entirely  or  to  reappear  in  a  milder 
form. 

Excellent  results  have  been  reported  from  the  use  of  the 
blue  light  in  hematomas,  sprains,  housemaid's  knee,  articular 
rheumatism  and  weeping  eczema. 

The  cure  of  a  case  of  lupus  by  means  of  this  light  is 
reported  by  Professor  Minin.  The  patient  had  resisted  a 
thorough  treatment  by  means  of  the  Finsen  method.  Others 
fail  to  confirm  his  claims. 

In  neuralgias  the  action  of  the  blue  light  is  to  increase  the 
pain,  because  it  increases  the  already  anemic  condition  of 
the  nerves.  In  these  cases,  massage  of  the  painful  nerve 
tract  with  a  ground  glass  incandescent  light  frequently  gives 
great  relief,  for  the  action  of  white  light  is  directly  opposite 
to  that  of  the  blue  light  and  increases  the  flow  of  blood  to 
the  parts. 

The  lamp  is  placed  just  near  enough  to  the  affected  part 
to  permit  the  feeling  of  slight  heat,  care  being  taken  not  to 
raise  a  blister.  Treatment  may  be  given  every  other  day 


208 


PRACTICAL    ELECTRO-THERAPEUTICS. 


for  fifteen  to  thirty  minutes,  or  oftener  as  conditions  may 
indicate. 

Parts  surrounding  the  sore  spot  may  be  gently  massaged 
to  improve  local  blood  circulation. 

This  lamp  is  placed  on  the  market  under  the  name  of 
Minin's  Ultra-Violet  Ray  outfit,  and  has  the  four  globes  of 
different  sizes  as  suggested  by  Professor  Minin. 

The  Multiple  Minin  Lamp  has  seven  globes  of  50  C.  P. 
each,  any  number  of  which  may  be  used  at  one  time,  and 
was  first  put  on  the  market  by  Betz  &  Co.  of  Chicago. 


The  Giant  Therapeutic  Lamp. 


RED  LIGHT  TREATMENT. 

At  the  present  time  there  is  a  difference  of  opinion  as  to 
whether  any  therapeutic  benefits  may  be  derived  from  the 
red  rays  themselves,  or  whether  their  sole  value  lies  in 
excluding  the  chemical  frequencies,  especially  the  ultra- 
violet. 

Finsen  by  a  series  of  experiments  proved  that  if  the 
chemical  frequencies  were  interrupted,  the  remaining  rays 
were  innocuous  to  smallpox  patients,  and  that  pustulation 
due  to  stimulation  of  the  secondary  streptococci  infection 
was  thus  avoided. 

The  exclusion  of  the  chemical  rays  must  be  absolute,  the 
inflamed  skin  being  as  sensitive  to  the  actinic  rays  as  a  photo- 
graphic film.  The  treatment  must  be  continued  without 
interruption  until  the  vesicles  have  become  dry.  The  short- 
est exposure  to  the  chemical  rays  or  daylight  is  apt  to 
produce  suppuration  with  its  sequelae.  Measles,  scarlet 
fever  and  erysipelas  patients  also  receive  marked  benefits 
from  the  exclusion  of  the  actinic  rays,  the  temperature  being 
lower  and  the  symptoms  in  general  are  less  severe  than  when 
exposed  to  the  full  effects  of  the  daylight.  Winternitz  is 
authority  for  the  statement  that  red  light  acts  favorably  in 
various  skin  diseases.  By  covering  up  with  red  material 
the  parts  of  the  body  exposed  to  the  sun  he  diminished 
hyperemia  and  cured  eczema.  The  action  obtained  being 
undoubtedly  due  to  the  absence  of  the  chemical  activities. 
He  also  claims  a  distinct  improvement  in  cases  of  chronic 
rheumatic  affections  of  the  joints,  hands  and  feet  in  the 
same  manner. 


14  209 


ELECTRIC  ARC  BATHS. 

The  use  of  electric  arc  lights  has  an  action  very  similar  to 
the  use  of  strong  sunlight;  in  very  susceptible  patients  a 
marked  erythema  frequently  occurs  in  from  fifteen  to  twenty 
minutes,  while  in  others  it  may  take  hours  to  bring  about 


•  Incandescent  and  Arc  Light  Bath. 

similar  results.  The  temperature  in  these  baths  is  very  low, 
it  being  necessary  to  warm  the  rooms  to  make  them  com- 
fortable for  the  patient. 

As  a  rule  the  rays  from  two  arc  lamps  of  ten  amperes  and 
fifty  volts  are  used,  each  lamp  giving  light  equal  to  two 
thousand  normal  candle-power.  The  duration  of  one  treat- 
ment varies  from  fifteen  minutes  to  forty-five  minutes.  The 
chemical  frequencies  in  which  the  electric  arc  is  very  rich 

210 


PRACTICAL    ELECTRO-THERAPEUTICS.  211 

are  not  bactericidal  in  themselves,  but  they  tend  to  pro- 
mote active  oxygenation  of  the  blood,  improving  metabolism 
and  consequent  nutrition,  which  in  turn  means  increased  re- 
sistance. 

No  claim  is  made  that  the  intense  chemical  rays  penetrate 
into  the  deeper  structures,  as  do  the  X-rays.  The  absorp- 
tion of  the  chemical  frequencies  of  the  electric  arc  by  the 
oxygen-carrying  corpuscle  in  the  superficial  blood  stream 
compels  its  influence  to  be  felt  in  every  part  of  the  body. 

These  electric  arc  baths  are  very  effective  in  the  treatment 
of  tuberculosis  (first  stages),  bronchitis,  muscular  rheuma- 
tism or  neuritis.  In  exposing  the  patient,  care  should  be 
taken  to  change  him  about  to  permit  every  part  of  his  body 
to  receive  the  direct  influence  of  the  light. 


ELECTRIC  LIGHT  BATHS. 


Sunlight  is  one  of  the  most  powerful  tonics  at  our  disposal, 
the  various  rays  being  present  in  the  highest  degree. 

Next  to  a  sun  bath  the  incandescent  electric  light  bath  is 
the  most  useful  and  sensible.  The  heat  in  this  bath  is  not 
derived  from  the  air  surrounding  the  patient,  as  in  a  hot  air 


Electric  L,ight   Bath. 

bath,  but  from  radiant  energy  from  the  incandescent  films. 
These  rays  pass  through  air  surrounding  the  patient,  without 
heating  it  to  any  considerable  degree.  As  the  rays  enter  the 
body  they  come  in  contact  with  various  opaque  structures, 
the  resistance  afforded  by  which  converts  radiant  energy 
into  heat. 

Rheumatic  individuals  have  noted  the  fact  that  when 
exposed  to  the  direct  rays  of  an  arc  lamp  their  condition 
seems  to  be  improved.  There  are  more  heat  rays  present 
in  an  incandescent  lamp  than  in  an  arc  lamp,  which  is  very 

212 


PRACTICAL    ELECTRO-THERAPEUTICS. 


213 


rich  in  actinic  rays,  which  are  a  direct  stimulant  for  animal 
and  vegetable  life. 

Light  rays  raise  the  body  temperature  the  same  as  hot 
water,  air  or  vapor.  This  rise  of  body  temperature  stimu- 
lates the  metabolic  activity  of  all  the  organs  of  the  body,  as 
is  indicated  by  an  increased  production  of  carbonic  acid. 
Animals  eliminate  more  carbon  dioxide  under  the  influence 
of  light  than  when  confined  in  the  dark. 

Exhaustive  experiments  show  that  frogs  throw  off  from 
one  twelfth  to  one  fourth  more  carbonic  acid  gas  in  the  light 
than  in  the  dark.  Experiments  on  dogs  and  rabbits  give 
similar  results. 


Local  Light  Bath. 

Metabolism  is  unquestionably  stimulated  by  the  reflex 
action  set  up  by  light  rays  upon  the  nerve  endings  of  the 
skin  and  retina.  Oxidation  is  increased  by  action  of  light  and 
less  carbon  dioxide  is  eliminated  at  night  than  during  equal 
hours  of  the  day,  even  if  an  equal  degree  of  rest  be  observed. 

The  stimulating  effect  of  light,  or  rather  heat  rays,  on  the 
nerve  endings  in  the  skin  brings  about  a  relaxation  of  the 
cutaneous  blood-vessels. 

The  dilated  cutaneous  vessels,  when  filled,  may  contain 
from  one  half  to  two  thirds  ot  tht  total  quantity  of  the  blood 
in  the  body,  thus  relieving  the  congested  visceral  organs, 
as  the  liver,  kidney,  stomach,  spleen  and  brain.  Owing  to 
cerebral  anemia  thus  brought  on,  the  patient  often  falls  into 
a  profound  slumber.  The  neating  of  the  blood  thus  brought 


214:  PRACTICAL    ELECTRO-THERAPEUTICS. 

to  the  surface  stimulates  the  sweat  glands  to  active  perspi- 
ration, and  may  increase  this  excretion  from  one  and  a  half 
ounces  to  two  or  three  pounds  per  hour. 

The  temperature  of  the  blood  in  these  widely  distended 
vessels  is  frequently  raised  from  four  to  five  degrees  Fahren- 
heit in  fifteen  minutes.  This  increase  in  body  temperature 
is  probably  the  cause  of  the  increased  production  of  carbon 
dioxide,  with  its  remarkable  reconstructive  effect  on  the 
animal  metabolism. 

General  perspiration  is  produced  faster  than  by  any  other 
known  procedure.  It  frequently  begins  in  three  to  five 
minutes  after  entering  the  bath,  the  temperature  of  which 
may  be  as  low  as  eighty-five  degrees.  In  a  Turkish  bath 
with  a  temperature  of  one  hundred  and  seventy  degrees 
Fahrenheit  it  takes  much  longer.  The  cutaneous  activity  is 
greater  than  under  any  other  sweating  procedure. 


Fig.  C. 

The  respiration  also  shows  an  increased  elimination  of 
carbon  dioxide,  amounting  at  times  to  forty-four  per  cent. 

The  electric  light  baths  are  fast  superseding  all  other  kinds 
of  sudatory  baths,  as  they  contain,  in  addition  to  decided 
benefits  of  their  own,  all  the  benefits  of  the  Turkish  or 
Russian  bath,  which  are  withheld  from  many  sufferers 
from  heart  troubles.  The  user  of  a  light  bath  is  in  reality 
enjoying  a  pleasant  sensation,  just  as  if  the  body  were 
exposed  to  a  mild  sunlight,  whereas  the  long-continued  use 
of  the  Turkish  or  Russian  bath  necessarily  causes  weak- 
ness. Light  baths,  on  the  contrary,  strengthen  and  give 
tone  to  the  system,  and  may  be  used  on  account  of  their 
strengthening  and  invigorating  qualities. 


PRACTICAL    ELECTRO-THERAPEUTICS.  215 

Locally  applied,  the  light  baths  are  most  effective  in  pro- 
moting absorption  of  exudates  from  joints  and  the  pleural 
and  peritoneal  cavities.  Even  absorptions  of  exudates  from 
the  cornea  and  vitreous  opacities  have  been  reported. 

The  arc  electric  light  bath  possesses  properties  identical 
with  those  of  the  sun's  rays;  in  the  arc  light  the  luminous 
and  the  chemical  rays  predominate;  in  the  incandescent  light 
the  heat  rays  predominate.  The  results  obtained  by  the  em- 
ployment of  this  bath  are  essentially  those  obtained  by  a  sun 
bath.  Patients,  however,  begin  to  perspire  more  quickly 
than  when  exposed  to  an  ordinary  sun  bath.  This  may 
perhaps  be  due  to  the  greater  number  of  actinic  rays  in  the 
arc  light,  which  exercise  a  powerful  stimulating  effect  upon 
the  sweat  glands,  the  duration  of  bath  being  from  five  to 
twenty  minutes. 

For  practical  purposes  the  incandescent  light  bath  sur- 
passes the  arc  light  bath. 

TECHNIQUE. 

No  light  bath  should  be  given  without  due  regard  to  the 
time  since  the  last  meal;  one  hour  and  a  half  after  a  light, 
and  two  hours  after  a  hearty  meal. 

The  duration  of  a  bath  may  be  continued  from  three  to  ten 
minutes  for  a  tonic  effect,  and  from  ten  to  thirty  minutes 
for  ejiminative  effects. 

Urge  patient  to  drink  water  copiously  to  encourage  dia- 
phoresis. 

Moisten  the  face  and  scalp  with  cloths  wrung  out  of  water 
at  a  temperature  of  sixty  to  sixty-five  degrees  F.  See  that 
the  feet  are  warm.  It  may  be  necessary  to  place  them  in  a 
basin,  of  warm  water. 

To  make  permanent  the  effects  obtained  by  the  light  bath 
they  must  be  followed  by  a  short  cold  application.  The 
application  of  cold  has  the  opposite  effects  to  heat  and  is  a 
powerful  stimulant  to  all  the  organs  of  the  body  and  a  power 
for  great  good.  It  improves  the  tone  of  the  organism  by 
the  reactionary  excitation  produced. 

In  feeble  individuals,  especially  those  suffering  from 
neuralgic  pains,  a  cold  douche  is  frequently  not  advisable. 
Here  alcohol  may  be  applied  to  a  small  area  at  a  time, 
and  friction  applied  until  it  evaporates.  The  entire  body 
should  be  gone  over  in  this  manner  to  bring  about  universal 
contraction  of  the  cutaneous  vessels. 


21(5 


PRACTICAL    ELECTRO-TIIF.RAPKUTICS. 


It  is  the  author's  custom  to  give  his  patients  the  benefit  of 
a  static  breeze  for  about  ten  minutes  after  each  bath,  to  make 
the  benefits  thus  obtained  more  permanent. 

Light  affects  the  great  majority  of  diseased  conditions  in 
the  most  favorable  manner,  especially  all  those  forms  of  dis- 
ease accompanied  by  defective  metabolism,  characterized  by 
defective  oxidation,  such  as  obesity,  diabetes,  uric  acid  diath- 
esis, gout,  Bright's  disease,  cirrhosis  of  the  liver,  rheumatism, 
etc. 


Acne,  eczema  and  even  psoriasis  have  yielded  surprising 
results  on  exposure  to  sunlight.  Spasm  of  the  cutaneous 
vessels  is  relieved,  permitting  the  blood  from  the  congested 
visceral  organs  to  come  to  the  surface.  Neurasthenia  in  all 
forms  is  materially  influenced  as  the  blood  improves. 

The  light  cabinet  is  especially  beneficial  in  toxic  insanity 
due  to  spirits  or  drugs,  melancholias,  nervous  insomnia  and 
the  various  symptoms  that  may  accompany  a  sclerotic  con- 
dition of  the  blood-vessels,  kidneys  and  liver,  various  degrees 
of  vaso-motor  paralysis,  tachycardia  and  arrhythmia,  due 
to  toxines,  are  notably  diminished  in  irregularity  during  the 
bath.  Strength  and  tone  frequently  continue  for  hours 
afterward. 

Albumen  and  casts  from  .the  kidneys  grow  less  and  fre- 
quently disappear  entirely  without  the  use  of  drugs.  The 


PRACTICAL    ELECTRO-THERAPEUTICS. 


217 


author  has  treated  a  number  of  cases  of  chronic  nephritis 
where  the  apex  of  the  heart  was  outside  the  nipple  line. 
After  three  months'  daily  treatment  it  was  found  to  have 
returned  to  almost  its  normal  position. 

Research  has  demonstrated  that  there  is  a  relationship 
between  every  portion  of  the  cutaneous  surface  with  some 
internal  area.  In  general,  it  is  the  skin  overlying  the  internal 
organ  that  is  reflexly  associated  with  it.  Understanding  this 
relationship,  it  is  readily  understood  that  the  volume  of  blood 


Local  Light  Bath. 

in  any  internal  organ,  no  matter  how  remote  from  the  surface, 
may  be  controlled  to  a  certain  extent  by  applications  to  the 
associated  cutaneous  area  of  a  thermic  or  other  agent  capable 
of  producing  vascular  change. 

Thus  congestions  of  a  reflex  nature  interfering  with  the 
perfect  action  of  an  organ  may  be  relieved  by  applications  of 
light  to  the  spine  from  the  base  of  cranium  down,  or  over 
the  reflex  cutaneous  surface. 


218 


PRACTICAL    ELECTRO-THERAPEUTICS. 


Prolonged  applications  of  light  and  heat  lessen  the 
excitability  and  energy  of  the  voluntary  muscles  (this  is  how 
heat  relieves  muscular  spasm)  and  greatly  increase  the 
excitability  of  the  smooth  involuntary  muscles. 

A  local  light  bath,  applied  to  the  hyperemic  tissues,  causes 
the  distended  capillaries  to  relax,  permitting  these  vessels 
to  fill  with  fresh  blood,  and  secures  a  more  rapid  and  complete 
oxidation  of  the  effete  materials,  which  are  clogging  the 
metabolic  processes,  into  normal  excretory  products,  in  which 
form  they  are  easily  disposed  of. 

A  three  hundred  candle-power  incandescent  lamp  (not 
brought  to  a  focal  point)  is  very  efficacious  in  the  treatment 
of  many  skin  diseases,  especially  so  in  the  various  eczemas. 
Carbuncles  may  be  aborted  if  the  light  is  applied  in  an  early 
period  of  development.  Pain  or  soreness  may  be  entirely 
relieved  or  greatly  modified. 


The  Carlsbad  Electric  Light  Bath  Cabinet. 


PART  II. 


NERVOUS  SYSTEM. 

ELECTRO-DIAGNOSIS. 

This  includes  examinations  of  the  electrical  reactions  of 
diseased  nerves  and  muscles.  It  presupposes  on  the  part 
of  the  investigator  a  thorough  knowledge  of  the  human 
anatomy,  physiology  and  pathology,  as  well  as  a  familiarity 
of  technique  with  electrical  appliances.  In  making  this 
examination  the  indifferent  or  positive  pole  is  placed  at  a 
distance,  and  the  negative  pole,  which  gives  the  strongest 
response,  is  used  as  the  active  electrode.  When  the 
minimum  response  is  compared  with  the  corresponding 
healthy  nerve  or  muscle  on  the  opposite  side  of  the  body,  it 
will  be  noted  that  similar  positions  of  the  coils  will  give 
similar  results. 

Normally,  the  first  contraction  in  the  series  is  always  on 
closing  the  circuit  with  the  cathode  (negative  pole),  and  the 
last  on  opening  with  the  cathode  (negative  pole),  anodic 
(positive),  opening  and  closing  contractions  appearing 
with  intermediate  current  strength.  The  current  strength 
necessary  to  elicit  cathodic  (negative)  opening  contractions 
is  usually  painful.  Stimulating  a  motor  nerve  stimulates 
the  muscle  to  which  it  is  supplied.  Muscular  tissue  is  a 
much  better  conductor  of  electricity  than  nerve  tissue,  with 
the  result  that  the  current  takes  the  path  of  least  resistance. 
Directly  on  enlering  the  nerve  it  leaves  and  passes  along  the 
surrounding  better  conductors. 

A  reaction  of  degeneration  exists  whenever  a  muscular 
response  presents  either  of  the  qualitative  changes.  The 
modal  alteration  from  the  quick  jerk  of  health  to  the  slow 
wave-like  movement  is  an  important  accompaniment  of 
degenerative  reaction,  and  points  infallibly  to  its  existence. 
The  phenomenon  is  readjly  detected  by  the  eye. 

A  diminution  or  total  extinction  of  faradic  irritability  is 
strong  presumptive  evidence  of  degenerative  reaction,  and  a 
quantitative  change  in  the  galvanic  irritability  are  the  quali- 
tative changes  which  usually  occur. 

Its   occurrence   indicates    positively  certain   pathological 

221 


222 


PRACTICAL    ELECTRO-THERAPEUTICS. 


Motor  Points  of  Body  and  Face. 

changes  in  the  nerves  and  muscles,  resulting  from  their 
more  or  less  complete  separation  from  their  trophic  centers 
in  the  ganglion  cells  of  the  anterior  cornea.  If  a  motor 
nerve  be  divided,  crushed  or  mutilated,  the  peripheral  portion 
will  degenerate.  In  two  or  three  days  the  medullary  sheath 
coagulates  at  the  point  of  injury  and  a  process  of  degenera- 


PRACTICAL    ELECTRO-THERAPEUTICS.  223 

tion  spreads  rapidly  toward  the  periphery  into  the  finest 
ramification  of  the  nerves,  resulting  in  a  cirrhosis  of  the 
nerves. 

Histological  changes  not  only  occur  in  the  injured  nerve, 
but  in  the  muscles  as  well,  finally  undergoing  waxy  or  fatty 
degeneration  until  the  muscle  mass  is  converted  into  a  tough 
band  of  connective  tissue. 

In  favorable  cases  regeneration  occurs,  but  only  after  the 
trophic  conductivity  of  the  nerve  has  been  restored.  All 
forms  of  degeneration  do  not  follow  the  typical  course,  for 
where  the  motor  conductivity  is  only  partially  interfered  with 
a  large  variety  of  phases  are  presented.  For  instance,  we 
may  have  complete  degeneration  in  one  part  of  a  large  muscle 
supplied  by  several  nerves  and  partial  degenerative  reaction 
in  another  part.  Here  we  are  apt  to  have  a  double  contrac- 
tion on  direct  stimulation  of  the  muscle,  the  healthy  portion 
contracting  quickly  and  the  degenerated  portion  contracting 
much  slower.  The  same  nerve  trunk  may  present  complete 
nerve  degeneration  in  one  part  of  its  course  and  the  partial 
form  in  another  portion. 

Diseases  in  which  reaction  of  degeneration  is  present  in 
certain  muscles  are  neuritis  of  motor  nerves  (traumatic  or 
idiopathic),  multiple  neuritis,  poliomyelitis,  bulbar  paralysis, 
lead  paralysis,  atrophic  lateral  sclerosis  (early  stages),  certain 
cases  of  diphtheritic  paralysis,  cases  of  myelitis  caused  by 
injury,  toxic  agents  or  pressure  of  intra-spinal  hemorrhages, 
tumors,  syphilitic  deposits  in  wjiich  there  is  a  partial 
degenerative  reaction  as  shown  above. 

The  examination  of  sensory  nerves  is  not  so  important  as 
that  of  motor  nerves,  though  it  is  more  accurate  than  other 
means  employed. 

The  reaction  of  degeneration  gives  a  definite  result  and 
enables  the  physician  to  form  a  prognosis  and  to  institute 
rational  treatment. 

Reaction  of  degeneration  at  once  excludes  the  brain,  the 
white  matter  of  the  cord,  hysterical  paralysis,  idiopathic 
muscular  atrophy  and  shamming. 

All  peripheral  diseases  in  which  the  integrity  of  the  nerves 
has  been  seriously  compromised,  as  the  result  of  injuries, 
pressure  or  morbid  growths  or  rheumatic  influences,  show 
the  usefulness  of  electrical  examinations. 

In  a  case  of  lessened  mobility  of  a  limb  or  muscle  it  will 


224  PRACTICAL    ELECTRO-THERAPEUTICS. 


Motor  Points  of  Arm. 


PRACTICAL    ELECTRO-THERAPEUTICS. 


225 


clear  up  the  question  between  a  cerebral  and  a  peripheral 
seat,  the  presence  of  a  full  f aradic  response  or  of  degenerative 
reaction  being  conclusive. 

An  examination  will  differentiate  between  cerebral,  per- 
ipheral and  lead  palsy,  and  in  unsuspected  cases  of  the  latter 
will  enable  a  diagnosis  to  be  made  in  the  absence  of  other 
conclusive  signs. 


Anodal  Electrolysis  in  Neuritis. 

From  the  above  list  it  will  be  seen  that  the  usefulness  of 
electrical  examinations  is  by  no  means  extensive,  yet  its 
indication  may  be  of  great  value. 

Nerves  of  special  sense  respond  to  electrical  stimulation 
with  a  sensation  corresponding  to  their  particular  function. 
The  cathode  (negative  pole)  is  more  irritating  than  the  anode 
(positive  pole).  The  supra-orbital  nerve  is  usually  chosen 
as  a  test  for  the  sensory  nerves,  and  response  is  usually 
most  marked  on  opening  and  closing  the  circuit. 

The  galvanic  current  is  used  in  making  this  examination. 

15 


22G  PRACTICAL    ELECTRO-THERAPEUTICS. 


Motor  Points  of  Lower  Extremity. 


PRACTICAL    ELECTRO-THERAPEUTICS.  227 

In  locomotor  ataxia  it  is  of  especial  value.  The  sensibility 
of  the  whole  body  is  often  found  very  much  decreased. 
Sensibility  to  pain  is  generally  affected  in  proportion  to  the 
general  sensibility.  In  certain  cases  there  is  complete 
analgesia.  When  the  affection  is  unilateral  the  difference 
of  the  farado-cutaneous  sensibility  on  the  two  sides  can 
often  be  clearly  brought  out. 

MODE  OF  PROCEDURE. 

Place  the  patient  in  an  easy  position  on  a  couch  or  chair 
opposite  the  examiner.  Place  the  indifferent  electrode  at 
some  distant  part  of  the  body,  the  sternum  for  instance, 
and  maintain  a  steady  contact.  This  electrode  should  be 
large  and  well  moistened,  so  that  local  action  will  be  kept  at 
a  minimum.  Start  with  the  negative  as  the  active  electrode. 
There  must  be  no  variations  in  the  conditions  under  which  the 
tests  are  made  other  than  the  change  of  polarity.  The  sponges 
should  be  well  moistened  in  bicarbonate  of  soda.  The  muscles 
of  the  parts  to  be  examined  should  be  relaxed.  The  active 
electrode  should  be  small,  say  four  fifths  of  an  inch  in  diame- 
ter. 

It  is  not  always  easy  to  find  the  motor  points  at  once,  not- 
withstanding the  operator's  knowledge  of  where  they  should 
be,  as  the  overlapping  of  muscles  and  adipose  tissue  and  the 
natural  variations  of  distribution  give  considerable  range  for 
variety  of  situation. 

We  begin  our  examination  with  the  faradic  current,  as 
it  has  a  diagnostic  value  peculiar  to  itself.  If  there  is  much 
degenerative  change  in  the  motor  nerve  or  muscle  structure 
they  fail  entirely  to  respond  to  the  brief  and  sudden  impulse 
of  the  induced  current.  If  a  muscle  or  nerve  is  found, 
therefore,  to  respond  to  the  induced  current,  this  in  itself  is 
evidence  that  the  muscle  is  not  undergoing  degeneration. 

In  making  a  diagnosis  of  diseases  of  children,  such  as 
infantile  paralysis,  where  it  is  necessary  to  know  the  exact 
condition  of  motor  nerves  and  muscles  as  a  guide  to  treat- 
ment, it  may  be  necessary  to  chloroform  the  child,  as  the 
currents  used  are  at  times  quite  uncomfortable  and  even 
painful. 

Note  the  weakest  current  that  induces  the  first  visible 
muscular  contraction.  After  having  examined  the  nerve 
trunk  to  test  its  irritability,  we  go  over  the  motor  points. 


PRACTICAL    ELECTRO-THERAPEUTICS. 

Repeat  this  with  the  galvanic  current  and  note  the  number 
of  milliamperes  needed  to  produce  the  first  visible  muscular 
contraction. 

It  is  very  important  to  know  whether  the  positive  or 
negative  pole  is  over  the  nerve,  and  whether  the  contraction 
occurs  at  the  opening  or  closing  of  the  circuit.  The  polarity 
of  the  electrode  may  be  changed  and  the  same  fact  determined 
for  the  minimal  contraction's. 

In  the  more  delicate  shades  of  degenerative  reaction  this 
mode  can  alone  be  depended  upon  to  give  exact  facts.  Pro- 
duce vigorous  contractions  at  cathode  closure  and  note  care- 
fully the  extent;  note  number  of  milliamperes  used.  Reverse 
the  pole  by  the  commutator.  Increase  or  diminish  the 
current  until  the  same  number  of  milliamperes  are  in  the 


Erb's  Electrodes. 

circuit  and  then  note  the  extent  of  the  contractions  at  the 
anode  closure. 

Complete  the  examination  by  similar  observation  at  anode 
opening  and  cathode  opening,  the  original  number  of 
milliamperes  being  carefully  maintained. 

The  irritability  of  a  nerve  is  increased  when  first  visible 
contraction  is  caused  by  a  current  of  less  strength  than  nor- 
mal, and  diminished  when  a  stronger  current  than  normal  is 
required  to  excite  muscular  contractions.  Increased  mus- 
cular irritability  is  present  in  the  early  stages  of  locomotor 
ataxia,  chorea,  etc. 

Having  found  the  spot  where  the  weakest  current  pro- 
duces the  greatest  individual  action  on  the  part  examined, 
it  is  marked  with  an  indelible  pencil  for  further  ease  in 
identification,  and  the  current  is  then  alternately  decreased 
and  interrupted  until  a  mere  trace  of  contraction  is  visible. 

Atrophy  from  disuse  and  from  inflammatory  joint  diseases 
is  characterized  by  diminished  irritability.  To  determine  with 


PRACTICAL    ELECTRO-THERAI'KUTICS.  221 

certainty  increased  nerve  irritability  the  resistance  of  the 
skin  over  the  parts  treated  must  be  accurately  measured. 

Muscles  react  to  the  faradic  current  in  the  same  manner 
as  they  do  to  the  motor  nerve.  The  faradic  current  contracts 
muscles  by  stimulating  the  intramuscular  nerve  fibers  and 
increases  the  irritability  of  motor  nerves.  There  is  little 
electrolytic  action  caused  by  this  current. 

A  slowly  interrupted  current  causes  contractions  of  the 
muscles  at  each  break  in  the  current,  while  the  rapidly  inter- 
rupted current  causes  tetanic  contractions,  the  muscle  having 
no  time  to  relax  between  each  electrical  stimulus  to  the  nerve. 

When  the  disease  is  unilateral,  the  opposite  healthy  side 
is  used  for  comparison.  If  the  disease  is  bilateral,  the  elec- 
trical reaction  should  be  compared  with  some  other  nerve  or 
muscle  whose  reactions  are  known  to  have  nearly  the  same 
value.  Any  of  these  nerves  may  be  taken  as  a  standard  of 
comparison  when  same  nerve  on  both  sides  is  involved.  We 
may  get  response  from  a  muscle  through  stimulation  of  the 
nerve  when  response  from  the  muscle  direct  gives  a  marked 
degenerative  reaction. 

Examinations  of  corresponding  sound  parts  are  used  as 
comparisons;  the  electrodes  in  size  and  current  interruptions 
must  be  the  same.  Equal  pressure  should  be  brought  to 
bear  on  the  electrode,  for  where  the  degenerative  changes 
are  slight,  carelessness  in  this  regard  may  leave  an  error  in 
diagnosis.  It  is  not  always  easy  to  determine  the  exact 
amount  of  current,  as  the  overlapping  muscles  and  adipose 
tissues  and  other  natural  variations  give  considerable  range 
in  variety  of  situation. 

The  disappearance  of  electro-nervous  excitability  coincides 
with  the  degeneration  of  the  nerve  structure. 

Farado-muscular  excitability  disappears  with  established 
degeneration  of  intramuscular  nerve  fibers  and  motor  end 
plates.  The  last  contraction  to  disappear  is  anodic  closure. 

If  regeneration  takes  place  in  the  nerve,  voluntary  impulses 
are  the  first  to  be  transmitted.  This  is  shortly  followed  by 
conduction  for  electrical  stimuli.  The  muscle  begins  to 
respond  more  sharply,  the  sluggish  contractions  gradually 
disappear  and  the  negative  takes  its  normal  position  in  the 
polar  series. 

When  we  propose  to  apply  electrical  stimulus  to  a  single 
muscle  the  active  electrode  must  be  applied  accurately  to 


230  PRACTICAL    ELECTRO-THERAPEUTICS. 

the  motor  point  of  the  muscle  or  the  motor  nerve  filaments 
supplying  the  muscle.  Care  must  be  taken  to  prevent  the 
current  from  reaching  muscles  that  should  not  be  stimu- 
lated, lest  our  object  in  giving  treatment  may  be  defeated, 
as  in  the  correction  of  deformities.  A  muscle  must  always 
be  stimulated  in  a  relaxed  condition,  and  a  disregard  of  this 
important  rule  makes  the  treatment  harmful  rather  than 
beneficial,  as  overstretching  of  the  fibrils  and  tendons  may 
take  place. 

Repeated  practice  in  locating  motor  points  on  oneself  as 
well  as  on  patients  is  necessary  to  acquire  proficiency  in 
electrical  diagnosis. 

SPINAL    DISORDERS. 

From  the  incurable  nature  of  most  spinal  cord  diseases, 
too  sanguine  predictions  must  not  be  made. 

In  some  instances  the  diseases  are  cured,  in  others  their 
course  is  arrested  and  alleviated,  while  in  still  others  not  even 
the  symptoms  are  relieved.  As  a  rule,  diseases  of  the  spine 
are  well  advanced  before  they  are  recognized.  Could  an 
early  stage  of  the  process  be  detected,  we  might  be  able  to 
arrest  it. 

For  the  special  anatomy,  physiology  and  pathology  of  the 
spinal  cord  the  reader  is  referred  to  the  standard  authorities. 
The  essential  point  in  the  treatment  relates  to  the  localization 
of  the  part  of  the  cord  affected.  The  most  invariable  effect 
due  to  electrical  stimulation  of  the  peripheral  nerves  ami 
their  end  organs  is  the  improved  nutrition  of  the  patient,  the 
patient  frequently  gaining  in  weight  irrespective  of  the 
improvement  which  may  or  may  not  ensue  in  the  disease. 
Just  how  much  stimulation  will  do  harm  or  how  much  do 
good  will  depend  upon  clinical  observation,  each  case  being 
a  law  unto  itself. 

The  morbid  processes  of  the  spinal  cord  are  divided  into  a 
number  of  classes: 

1.  Functional. 

2.  Nutritional. 

3.  Anemic  and  hyperemic. 

4.  Hemorrhagic. 

5.  Neoplastic. 

6.  Inflammatory. 

7.  Degenerative. 


PRACTICAL    ELECTRO-THERAPEUTICS.  231 

If  we  exclude  the  hemorrhagic  and  neoplastic,  which  are  of 
rare  occurrence,  the  remaining  pathological  states  are  more 
or  less  interwoven,  their  nature  being  that  of  a  chronic  fibroid 
condition.  The  sclerotic  process  is  an  active  one  and  not 
one  of  decay,  nutrition  being  very  active. 

Toxic  agents,  as  alcohol,  lead,  etc.,  and  the  poisons  of 
infectious  diseases,  fatigue,  overexertion,  imperfect  metab- 
olism, auto-intoxication,  due  to  uric  acid,  etc.,  produce  a 
neuro-paralytic  condition.  What  is  more  natural  than  that 
the  nerve  cell,  bathed  in  a  fluid  toxic  to  its  nutrition  and 
life,  should  die? 

Toxic  paralyses  are  peculiar  in  that  they  begin  their 
recovery  the  moment  the  poison  is  eliminated.  Oxygenation 
of  the  tissues  effected  by  electricity  at  once  becomes  a  ques- 
tion of  prime  importance.  Weak  galvanic  currents  should 
be  passed  through  the  paralyzed  limb  or  limbs.  Static 
electricity  may  be  used  as  a  general  nerve  tonic. 

If  it  is  desired  to  produce  excitation,  the  interrupted  gal- 
vanic current  is  used,  while  if  sedative  effects  are  desired, 
apply  the  anode  (positive  electrode)  of  the  galvanic  current. 
If  we  wish  to  excite  generally,  we  place  the  anode  (positive 
electrode)  at  the  feet  and  move  the  cathode  (negative  elec- 
trode) up  and  down  gradually  over  the  whole  body  surface, 
and  frequently  interrupt  or  change  the  current  direction.  If 
we  wish  to  excite  cutaneous  anesthesia  or  muscular  atony, 
the  whole  surface  of  the  body  may  be  gone  over  by  the  faradic 
brush  or  wet  sponges.  When  there  is  increased  excitability, 
faradism  is  contraindicated.  The  venous  engorgement  of 
the  extremities  found  in  paretic  stupor  improves  v/hen 
treated  by  the  interrupted  or  labial  galvanic  current. 

In  making  a  spinal  application  the  patient  may  sit  side- 
ways on  a  chair  with  clothing  loosened  at  the  back.  Two 
spinal  electrodes  are  used,  about  two  and  a  half  by  five  inches, 
the  positive  being  placed  immovable  on  the  lumbar  region 
and  the  negative  held  in  contact  with  the  cervical  and  various 
parts  of  the  median  and  dorsal  region,  and  in  turn  giving  a 
stabile  or  stationary  current  in  each  region  for  one  minute. 
A  current  of  ten  to  seventy  milliamperes  may  be  used, 
according  to  the  patient's  tolerance.  The  faradic  current 
is  not  employed  in  this  manner,  as  it  would  doubtless  fail  to 
act  on  the  cord  or  deep-seated  nerve  roots.  A  more  effec- 
tive application  than  this  is  the  abdomino-dorsal  application, 


232 


PRACTICAL    ELECTRO-THERAPEUTICS. 


placing  a  large  pad  upon  the  abdomen  and  sliding  the 
thoroughly  soaped  electrode  up  and  down  the  back,  using 
about  forty  milliamperes,  more  or  less,  according  to  the 
patient's  tolerance. 

Long  percussive  sparks  to  the  vertebral  column,  small 
sparks,  such  as  are  easily  borne,  to  the  muscles,  friction  or 
rubbing  the  electrode  over  the  entire  skin  surface,  and  a 
Leyden  jar  current,  are  especially  useful  in  spinal  cord  dis- 


Using  Faradic  Brush  for  Cutaneous  Stimulation. 

eases.  No  chemical  decomposition  attends  its  flow,  but  in 
place  of  this  great  molecular  disturbance  takes  place.  The 
resistance  of  the  human  body  is  practically  nil  to  this  current, 
it  being  especially  adapted  to  reaching  and  influencing  the 
spinal  marrow. 

Infantile  paralysis  offers  frequent  indications  for  the  use 
of  electricity.  The  muscles,  whose  faradic  contractility  is 
only  partially  lost,  may  be  expected  to  recover  completely, 
either  spontaneously  or  under  treatment. 

The  injury  of  an  organism  or  any  part  of  it  during  its 
epoch  of  growth  produces  a  much  more  profound  effect  than 


PRACTICAL    ELECTRO-THERAPEUTICS.  233 

if  received  after  growth  has  been  completed,  when  it  is  only 
necessary  to  maintain  the.  status  of  nutrition. 

We  are  not  justified  in  waiting  for  spontaneous  recovery. 
The  aim  should  be  to  allay  the  hyperemia  of  the  spinal  cord, 
which  is  one  of  the  elements  of  the  initial  myelitis  when  this 
really  exists,  and  when  the  paralysis  is  not  due  to  peripheral 
neuritis. 

The  arrest  of  the  circulation  which  occurs  at  the  beginning 
of  inflammation  can  be  dissipated,  provided  the  blood-vessels 
have  not  yet  become  agglutinated,  hence  its  value,  in  creep- 
ing inflammations  of  the  nerve  centers.  Electric  currents 
promote  circulation  in  the  blood-vessels  and  lymphatics. 

The  conductivity  of  the  axis  cylinder  of  nerves  should  be. 
maintained  by  the  passage  of  constant  electrical  currents, 
as  a  substitute  for.  the  nervous  currents  which  have  ceased 
to  pass,  and  to  maintain  the  nutrition  of  the  muscles  by  means 
of  electrical  stimulation  in  place  of  volition.  The  constant 
current  contributes  to  the  nutritive  regeneration  of  gan- 
glion cells,  nerve  fibers,  muscle  fibers,  by  its  catalytic  influ- 
ence, and  promotes  the  development  of  adjacent  neuro-vas- 
cular  elements  to  assume  the  functions  of  those  hopelessly 
destroyed. 

In  an  exposed  nerve  traversed  by  a  constant  current  the 
excitability  of  the  segment  at  the  positive  pole  is  diminished. 
At  the  negative  pole  it  is  increased.  This  is  one  of  the 
fundamental  laws  of  electric  physiology.  By  the  prolonged 
passage  of  the  current  a  nerve  may  be  completely  paralyzed, 
so  that  for  a  while  it  ceases  to  respond  to  faradic  stimulation. 
This  experiment  shows  why  the  positive  pole  of  the  galvanic 
current  acts  as  a  sedative  agent  to  nervous  irritation. 

As  these  cases  frequently  recover  spontaneously,  it  is 
difficult  to  prove  the  nutritive  value  due  to  faradic  contrac- 
tions. The  distinguishing  characteristic  of  the  faradic  cur- 
rent is  that  it  elicits  and  promotes  functional  activity,  and 
this  is  only  indirectly  and  under  favorable  circumstances  a 
stimulant  to  nutrition.  Since  the  functional  activity  implies 
and  depends  on  the  processes  of  disassimilation,  it  would 
seem  at  first  as  if  such  activity  should  be  sedulously  avoided 
in  cases  of  paralysis,  and  only  rest  sought.  The  muscular 
atrophy  occurring  in  many  cases  of  paralysis  is  due  largely 
to  inaction;  hence  artificial  stimulation  must  be  resorted  to 
to  a  limited  degree. 


234 


PRACTICAL    ELECTRO-THERAPEUTICS. 


Infantile  paralysis  may  require  treatment  for  a  long  time 
before  recovery.  A  period  of  two  years  may  frequently  be 
assigned  in  advance. 

In  acute  poliomyelitis  the  treatment  may  begin  as  soon  as 
the  signs  of  the  acute  inflammatory  stage  are  over.  This  is 
often  as  early  as  the  second  week.  Employ  the  galvanic 
current  upon  the  cervical  or  lumbar  enlargements.  The  site 
of  the  disease  is  covered  with  a  large  electrode,  while  the 


Faradic  Stimulation. 

other  electrode  is  applied  to  the  anterior  part  of  the  body. 
By  the  aid  of  a  pole  changer  first  the  positive  and  then  the 
negative  poles  may  be  employed  for  one  or  two  minutes  each. 
The  negative  electrode  may  also  be  placed  stabile  over  the  site 
of  the  disease  and  labile  or  stabile  to  the  nerve  trunks  or 
muscles,  the  anode  (positive  pole)  being  placed  at  an  indiffer- 
ent point,  as  in  the  hand  or  on  the  sternum. 

In  paralysis  of  the  milder  forms  the  reactions  are  all 
normal,  paralysis  being  only  a  symptom,  the  nerve  trunk 
being  incapacitated  by  disease  for  carrying  motor  impulses. 


PRACTICAL    ELECTRO-THERAPEUTICS.  235 

Where  a  single  group  of  muscles  is  involved,  the- disease  is 
generally  confined  to  the  nerve  trunk  supplying  this  group. 

The  study  of  the  reaction  of  degeneration  locates  the  seat 
of  the  lesion  and  separates  in  a  broad  way  diseases  of  spinal 
and  cerebral  origin,  and  excludes  hysteria  and  shamming. 
Nevertheless,  we  must  remember  that  grave  spinal  and 
cerebral  lesions  may  be  present  and  nearly  normal  electrical 
reactions  take  place. 

It  may  be  stated  as  a  general  rule  that  the  more  complete 
the  reactions  of  degeneration,  and  the  longer  they  have  been 
manifest,  the  more  unfavorable  the  prognosis. 

If  the  electrical  reaction  is  normal,  the  disease  may  dis- 
appear in  a  few  weeks. 

If  partial  reaction  of  degeneration  is  present,  the  disease 
usually  lasts  a  few  months,  and  when  reaction  of  degeneration 
is  complete,  the  disease  usually  lasts  from  six  to  nine  months 
or  even  longer. 

In  making  a  -prognosis,  the  etiology  of  the  disease  must, 
however,  always  be  taken  into  consideration. 

In  diphtheritic  paralysis  the  cord  is  only  exceptionally 
affected.  The  paralysis  usually  is  peripheral  in  character 
and  tends  to  spontaneous  recovery,  but  the  rapidity  of  the 
progress  depends  on  the  functional  nutrition.  If  this  is 
imperfect  the  paralyzed  condition  may  drag  on  for. months. 
In  case  nerve  degeneration  and  muscular  atrophy  supervene, 
the  paralysis  may  become  permanent.  Hence  it  is  important 
to  aid  nutrition  by  means  of  drugs.  General  faradization  is 
indicated,  although  local  applications  may  be  made  directly 
to  the  pharynx.  The  faradic  current  is  preferable  to  the 
galvanic.  If  the  galvanic  is  employed,  it  must  be  without 
interruptions,  which  tend  to  exhaust  the  affected  muscles. 

Study  the  nerve  distribution  from  the  spine  to  the  affected 
region.  A  contractured  muscle  after  an  injury  may  bring 
direct  pressure  on  a  nerve  firmer,  or  a  plexus,  cutting  off  its 
function  and  causing  paralysis  in  its  area  of  distribution.  In 
such  cases  the  result  is  seen  directly  upon  the  parts  supplied 
by  the  combined  nerves;  it  is  uncomplicated  in  other  parts 
of  the  body  and  is  manifested  in  a  circumscribed  area;  namely, 
in  muscle  groups  supplied  by  the  nerve  or  nerves  in  ques- 
tion. 

If  the  trouble  is  due  to  an  auto-intoxication,  such  as 
we  find  in  anterior  poliomyelitis,  where  the  source  of  trouble 


236  PRACTICAL    ELECTRO-THERAPEUTICS. 

lies  in  the  bowels,  we  frequently  find  that  flushing  of  bowels 
and  the  hot  air  bath  to  eliminate  the  poison  from  the  system, 
as  well  as  stimulation  of  liver  and  kidneys,  are  of  great  aid. 

It  may  not  be  amiss  here  to  acknowledge  the  value  of 
lymph  hypodermatically  administered,  in  cases  of  paralysis 
due  to  auto-intoxication  or  auto-infection.  Early  administra- 
tion is  advised. 

A  child  suffering  from  a  severe  gastro-enteric  infection 


Anodal  Electrolysis  for  Neuritis. 

developed  marked  cerebral  symptoms.  Paralysis  of  the  optic 
nerves  and  absence  of  reflex  ta  light  were  present.  The 
child  had  slept  with  its  eyes  wide  open,  even  when  under  the 
influence  of  an  opiate,  which  had  to  be  administered  to  prevent 
shrieking  and  restless  tossing  about.  This  condition  had 
been  going  on  for  about  a  week  when  the  patient  was  seen  in 
consultation  by  two  specialists,  who  made  an  unfavorable 
prognosis — they  had  never  seen  a  child  with  such  severe 
involvement  recover  the  use  of  its  faculties.  It  occurred  to 
the  author  that  as  the  use  of  lymph  had  been  followed  by 


PRACTICAL    ELECTRO-THERAPEUTICS.  237 

favorable  results  in  case  of  adults,  it  might  be  employed  in 
this  case,  while  the  active  cause  was  still  in  progress.  Two 
injections  were  made  four  hours  apart,  and  were  followed  by 
a  normal  sleep  with  closed  eyes.  A  marked  improvement 
was  noticeable  after  eight  hours.  Three  injections  a  day 
were  made  for  the  next  four  days.  At  the  end  of  this  time, 
the  child  had  recovered  the  use  of  all  its  faculties  and  was 
able  to.  recognize  everything  that  was  going  on,  even  calling 
for  his  playmates. 

If  the  action  of  the  trophic  centers  in  the  cord  which  con- 
trol the  nutritive  processes  is  impaired,  thereby  complicating 
the  paralysis,  the  parts  affected  rapidly  become  soft  and 
atrophy.  In  brain  lesions,  the  trophic  centers  not  becoming 
involved,  the  motor  mechanism  suffers  only  from  disuse, 
and  thereby  secondarily  affects  general  nutrition.  In  per- 
ipheral paralysis,  if  exercise  of  other  parts  of  the  body  is 
not  impaired,  only  the  part  paralyzed  suffers. 

Stimulation  tends  to  preserve  the  balance  of  nutrition, 
which  is  restored  and  degeneration  thereby  retarded.  If  it 
is  due  to  a  blood  clot  on  the  brain  or  congestion  of  the  brain 
or  cord,  or  embolism,  stimulate  the  cervical  centers  of 
circulation  to  assist  in  its  absorption.  This  can  be  accom- 
plished where  the  clot  has  not  had  time  to  become  organized 
or  encysted. 

In  paralysis  the  wave  current  should  be  applied  over  the 
organ  itself  and  the  trophic  centers  in  the  spine,  increasing 
nutrition  and  relieving  arterial  tension.  Activity  in  the 
organs  is  quickened  and  absorption  hastened,  removing  the 
pathological  condition  and  establishing  collateral  circulation 
in  the  parts  previously  cut  off. 

Contractions  as  a  rule  do  not  take  place  in  the  paralyzed 
limb  during  treatment.  A  treatment  should  last  at  least 
twenty  minutes,  with  about  a  four-inch  spark-gap.  The 
high  frequency  current  is  also  a  great  aid  in  these  cases  and 
relief  is  sometimes  very  speedy,  especially  if  the  trouble  be 
of  central  origin.  One  electrode  is  placed  over  the  sensitive 
spot  of  the  brain  (which  is  easily  localized  by  means  of  the 
electrode),  while  the  other  is  placed  over  the  nerves  supply- 
ing the  parts. 

In  chronic  cases,  soften  the  contracture,  build  up  the 
circulation,  increase  the  nutrition  to  the  tissues  and  tone  up 
the  local  nerve  mechanism. 


238 


PRACTICAL    ELECTRO-THERAPEUTICS. 


In  treating  the  muscles  of  the  face  an  electrode  handle 
should  be  used  which  permits  the  opening  and  closing  of  the 
circuit  without  removing  the  electrode  from  the  surface  of 
the  skin.  Treatments  should  be  every  other  day. 

In  facial  paralysis  the  muscles  can  be  stimulated  by  the 
induced  faradic  current  from  static  machine  with  much  less 
pain  to  the  person  than  either  galvanic  or  faradic.  This  is 
especially  valuable  in  treating  children. 


Faradic  Current  in  Facial  Paralysis. 

In  atrophic  paralysis  the  galvanic  current  is  superior  to 
the  faradic  current.  It  excites  a  movement  of  the  liquids 
in  the  plasma  of  tissues  favorable  to  nutrition,  while  it 
arouses  no  function  in  either  muscle  or  nerve.  There  is 
no  danger  of  fatiguing  either  from  premature  activity.  The 
reason  why  the  faradic  current  may  be  beneficial  is  that  it 
does  not  reach  the  wasted  ganglion  cells,  and  if  limited  to 
the  skin  by  a  dry  brush,  does  not  penetrate  to  the  paralyzed 
muscles  or  motor  nerve. 

With  static  electricity  success  is  obtained  only  in  cases  of 
recent  paralysis,  and  in  cases  \vhere  the  disease  advances 


PRACTICAL    ELECTRO-THERAPEUTICS.  239 

slowly.  There  is,  of  course,  no  remedy  that  will  resurrect 
a  dead  cell.  In  many  cases  the  vitality  of  the  neuro-muscular 
elements  is  so  profoundly  smitten  that  recovery  is  impossible, 
for  the  injury  may  have  been  so  widely  distributed  that 
no  element  remains  intact. 

In  diseases  of  the  brain  electricity  is  considered  useless  by 
many,  while  some  claim  that  it  permanently  injures  the 
nervous  system  of  children. 

There  is  no  form  of  nervous  trouble  or  disorder  where  the 
various  forms  of  electricity  are  more  serviceable  in  effecting 
a  restoration  to  normal  conditions  than  in  neuritis.  It 
assists  nature  in  clearing  up  the  debris  resulting  from  the 
invasion  of  inflammatory  exudates,  thus  removing  the 
vulnerable  condition  of  the  nerve  trurik,  which  makes  it  prone 
to  a  recurrence  on  slight  provocation. 

The  operator  possessing  a  good  working  knowledge  of  the 
physical  and  physiological  effects  of  the  various  electrical 
modalities,  and  having  made  out  the  pathological  state  of 
his  patient,  has,  as  a  rule,  no  difficulty  in  choosing  that  form 
of  electrical  action  best  adapted  to  meet  and  counteract  the 
abnormal  states. 

In  trauma,  over-stimulation  will  retard  rather  than  pro- 
mote the  nutrition  and  restoration  of  nerve  function.  The 
treatment  should  be  the  application  for  five  to  ten  minutes 
daily  of  the  galvanic  current,  followed  or  preceded  by 
vibratory  massage  and  Swedish  movement,  and  will  be  quite 
sufficient.  The  length  and  vigor  of  treatment  should  be 
increased  as  the  nerve  begins  to  respond  more  actively. 
When  the  function  has  been  restored  the  induction  coil  cur- 
rent, with  slow  interruptions,  can  be  substituted  for  the 
direct  current.  Gentle  contraction  of  the  muscle  supplied 
by  nerve  may  be  thus  effected,  and  in  order  to  arouse  the 
sensory  nerves  the  faradic  brush  should  be  passed  over  the 
area  of  sensitive  distribution  with  a  current  strength  quite 
perceptible  to  the  patient. 

Lesions  of  the  olfactory  and  optic  nerves  are  not  amenable 
to  electrical  treatment  by  galvanic  current.  The  application 
of  the  electrode  to  the  optic  conjunctiva  is  exceedingly 
painful.  Indeed,  it  is  possible  to  injure  the  refractive 
media  of  the  organ  with  too  strong  a  current.  . 

In  perverted  functioning  of  the  brain,  arising  from  either 
nutritive  or  circulatory  disturbances,  the  indications  for 


24D 


PRACTICAL    ELECTRO-THERAPEUTICS. 


its  use  are  generally  empirical.  In  many  cases  the  nature 
of  the  trouble  forbids  more  than  a  hope  of  amelioration, 
while  in  others  unexpected  results  have  followed  its  use. 
The  first  point  to  be  considered  is  the  form  of  electricity  to 
be  used. 

A  galvanic  current  of  great  amperage  affects  the  brain, 
the  spinal  cord  and  the  sympathetic  system  more  powerfully 
than  currents  of  even  the  highest  tension.  The  amperage 


Galvanic  Stimulation  of  Trophic  Centers  in  Spine  and  Solar  Plexus. 

also  gives  it  a  more  potent  electrolytic,  and  thermic  action 
and  also  greater  influence  on  the  secretions. 

A  current  of  from  three  to  thirty  milliamperes  may  be 
applied  for  a  minute  or  more,  according  to  the  susceptibility 
of  the  patient.  Begin  with  a  weak  current  and  increase 
until  the  metallic  taste  is  perceived  in  the  mouth.  The 
cranial  center,  the  summit  between  the  ears,  is  especially 
important  in  central  galvanization.  A  current  traversing 
from  this  point  to  the  solar  plexus  is  sure  to  affect  an 
intensely  vital  area.  Avoid  sudden  interruptions  in  giving 
applications  to  the  head. 


PRACTICAL    ELECTRO-THERAPEUTICS.  241 

The  current  should  not  be  strong  enough  to  produce 
cutaneous  irritation.  The  vaso-motor  action  of  the  current 
is  the  one  chiefly  desired  in  brain  diseases,  hence  the  galvanic 
current  is  largely  used,  though  either  current  may  be  used. 
Where  there  is  a  congested  disk  there  is  contraindication 
to  the  use  of  faradic.  The  current  should  be  two  to  five 
milliamperes,  one  electrode  on  the  forehead  and  the  other  on 
the  nape  of  the  neck  or  over  solar  plexus,  the  treatment 
lasting  from  three  to  five  minutes. 

In  applying  electricity  to  the  brain  a  large,  well-moistened 
flexible  electrode  should  be  used,  the  hair  also  should  be 
moist  at  point  of  application,  and  great  care  should  be 
exercised  in  turning  the  current  on  and  off. 

In  the  use  of  the  poles  the  best  results  are  obtained  by 
using  both  poles  successively  at  each  point  of  application. 
If  we  wish  to  increase  the  flow  of  blood  to  the  brain  the 
negative  pole  is  placed  over  the  forehead,  and  if  we  wish  to 
diminish  the  flow  of  blood  to  the  brain  the  positive  electrode 
is  used. 

If  the  galvanic  current  is  passed  from  the  forehead  to  the 
occiput,  or  from  the  summit  of  the  head  to  the  stomach, 
little  vertigo  follows.  If,  however,  the  current  be  passed 
from  temple  to  temple  or  from  mastoid  to  mastoid,  a  very 
decided  dizziness  at  once  appears  and  becomes  more  decided 
the  moment  the  circuit  is  broken. 

Whenever  the  expected  results  do  not  follow  the  theoretic- 
ally indicated  pole,  the  contrary  pole  should  be  tried.  The 
gal vano- faradic  current  is  sometimes  very  effective  as  a 
tonic  when  everything  else  fails. 

In  mental  diseases,  which  are  usually  indications  of  deep- 
seated  organic  changes  in  the  cerebrum,  the  symptoms  are 
frequently  successfully  combated.  Many  cases  of  mental 
derangements,  insomnia,  extra  and  -intra-cephalic  changes, 
congestions  of  the  face,  epigastric  oppression,  false  percep- 
tions of  sense,  such  as  taste  and  hearing,  may  be  successfully 
treated.  The  galvanic  current  controls  these  factors  by 
re-establishing  the  deranged  circulatory  conditions  and  con- 
trolling the  factors  which  cause  the  mental  trouble. 
Turgescence  of  the  veins  of  the  brain  really  constitutes  a 
withdrawal  of  so  much  blood  from  the  efficient  circulation. 

Electricity,  if  used  carefully  and  perseveringly,  may  be  a 
valuable  remedy.  Weak  currents  excite  and  stimulate  the 

16 


242 


PRACTICAL    ELECTRO-THERAPEUTICS. 


circulation,  a  medium  current  promotes,  strong  ones  hinder 
it  and  very  strong  extinguish  it.  Hence  it  follows  that 
strong  currents  should  never  be  used.  Where  it  is  desired 
to  produce  a  change  in  nutrition  the  constant  current  should 
be  used,  the  anode  (positive  electrode)  being  placed  at  the 
back  of  the  head  and  the  cathode  (negative  electrode)  placed 
at  the  extremities  in  the  form  of  a  foot  plate,  metal  plate  or 
sponges. 


Central  Galvanization. 


Hallucinations  and  fixed  ideas  are  disorders  which  are  fre- 
quently amenable  to  electrical  treatment.  The  positive  pole 
may  be  applied  to  the  superior  cervical  ganglion  of  the  great 
sympathetic  on  each  side,  and  negative  pole  moved  slowly  on 
the  same  side  from  the  region  over  the  eyebrow  to  the 
occiput.  The  periods  of  treatment  may  vary  from  a  week 
to  a  year.  Developmental  insanities  and  morbid  mental 
irritabilities,  due  to  rapid  growth,  have  been  effectively 
treated  with  electricity.  Insanity  of  the  climacteric,  which 
usually  takes  the  form  of  mania  or  melancholia  and  in  lac- 


PRACTICAL    ELECTRO-THERAPEUTICS.  243 

tational  insanity  excellent  results  have  been  reported  from  its 
use.  In  general  paralysis  of  the  insane  alleviation  may  be 
looked  for.  The  insane  condition  frequently  found  in  aged 
people  usually  arises  from  nutritive  enfeebleness  and  is 
most  amenable  to  treatment,  and  next  to  careful  alimenta- 
tion, electricity  is  the  most  valuable  therapeutic  remedy  for 
this  trouble. 

Psychic  disorders  having  their  sources  in  exhaustion  and 
overwork  frequently  respond  to  the  static  current.  Elec- 
tricity is  of  little  use  in  attacks  of  mania,  though  many  cases 
of  improvement  under  its  use  are  reported. 

The  results  obtained  by  electricity  in  cerebral  hemor- 
rhages have  been  variable,  but  owing  to  the  lack  of  other 
remedies  its  use  is  almost  always  justifiable.  The  applica- 
tions should,  of  course,  be  deferred  until  the  danger  from 
cerebral  fever  has  subsided.  The  treatment  consists  in 
galvanization  of  the  injured  portion  of  the  brain,  as  well  as 
of  the  injured  muscles.  Faradism  of  the  brain  is  always 
contraindicated,  weak  currents  doing  no  good  and  strong 
currents  liable  to  do  harm.  By  the  peripheral  treatment  of 
the  muscles,  etc.,  the  brain  is  also  reflexly  stimulated  to  assist 
in  the  restoration  of  conduction  to  the  motor  nerve  tract. 

In  hemiplegia  the  large  electrode  of  the  positive  pole  is 
applied  to  the  nape  of  the  neck  and  the  other  is  placed  on  the 
diseased  side,  so  as  to  include  the  lesion  between  the  two. 
The  hair  should  be  well  moistened.  The  treatment  is  much 
the  same  for  all  cerebral  paralysis,  varying  only  with  the 
seat  of  the  lesion  and  the  affected  muscles.  Should  there  be 
paresis  or  paralysis  of  the  diaphragm  faradization  of  the 
phrenic  nerve  is  indicated. 

Headaches. — The  treatment  of  this  trouble  should  be  pre- 
ceded by  a  careful  investigation  into  the  cause  and  the  treat- 
ment directed  to  the  starting  point. 

In  practically  all  forms  of  headaches  there  are  contractions 
of  the  cervical  spinal  muscle.  These  contractions  are,  as  a 
rule,  easily  relaxed  by  means  of  the  static  spray  or  high 
frequency  application.  As  the  vaso-motor  system,  control- 
ling the  circulation  of  the  body,  has  its  location  here,  relaxa- 
tion of  these  muscles  and  ligaments  has  a  marked  influence 
in  relieving  headaches;  at  least,  temporarily.  Manipulation 
or  manual  pressure  over  the  vaso-motor  nerve  centers  about 
the  head,  face  and  neck  will  frequently  relieve  a  headache. 


244 


PRACTICAL    ELECTRO-THERAPEUTICS. 


Congestive  headaches  are  frequently  relieved  by  application 
of  the  high  frequency  current;  the  operator,  holding  the  glass 
electrode  in  one  hand,  applies  the  current  to  the  patient's 
head  with  the  other.  To  begin  with,  the  spark-gap  must  be 
very  small,  and  the  current  should  be  hardly  perceptible  to 
the  operator's  hands.  A  half-inch  spark-gap  may  cause  the 
patient  to  faint.  In  making  application  to  the  patient's  head 
a  number  of  intensely  sore  spots  are  usually  found,  which 


Central  Galvanization. 

will  disappear  after  a  few  moments'  application,  when  the 
spark-gap  may  be  widened. 

It  has  been  suggested  that  this  means  might  be  utilized  in 
making  diagnoses  and  in  locating  brain  tumors. 

Chronic  headaches  at  the  base  of  the  occiput  are  frequently 
relieved  by  placing  the  positive  electrode  over  this  region, 
with  the  indifferent  electrode  in  the  hands  or  on  some  other 
part  of  the  patient's  body.  The  current  strength  to  be 
applied  must  be  governed  by  the  patient's  sensitiveness. 

The  Pain  of  neuralgia  is  usually  due  to  pressure  on  the  nerve 


PRACTICAL    ELECTRO-THERAPEUTICS.  245 

filaments  by  spasm  of  its  nutrient  vessels,  as  well  as  by  com- 
pression of  the  nerve  trunks  by  the  overfilling  of  the  blood- 
vessels in  the  contiguous  area.  Consequently  the  pain  is 
often  relieved  by  simple  relaxation  of  the  nutrient  vessels  in 
the  nerve  trunks,  drawing  away  the  stagnant  stream  of 
nutrient  material. 

In  neuralgia  of  the  fifth  nerve,  cervico-occipital  neuralgia, 
cervico-brachial  neuralgia,  it  is  absolutely  necessary  to  bring 
about  a  relaxation  of  the  muscular  fibers  of  the  neck. 
Manipulation  of  the  muscles  of  the  neck,  with  moderate  pres- 
sure and  vibration  over  the  painful  locality,  frequently  brings 
relief  in  two  to  three  minutes. 

Prompt  relief  from  pain  is  frequently  obtained  from  gal- 
vanism in  neuralgia  and  it  certainly  exercises  a  curative 
influence.  Spinal  tenderness  is  often  completely  cured  by 
electrization.  Electricity  may  relieve  the  pain  and  not  affect 
the  pathological  process,  which  may  be  uninfluenced  and 
run  the  regular  course. 

In  applying  electricity  the  rule  is  to  use  the  weakest  current 
which  will  produce  perceptible  action,  but  no  violent  con  • 
tractions.  The  anode  (positive  pole)  should  be  placed  over 
the  seat  of  pain,  successively,  at  the  points  of  emergence  of 
the  several  nerves,  the  cathode  (negative  pole)  being  firmly 
fixed  over  the  upper  surface  of  the  vertebra.  Avoid  inter- 
ruptions of  the  circuit.  Apply  daily  for  ten  minutes. 

In  sciatica  release  the  tissues  along  the  entire  course  of 
the  nerve.  This  is  accomplished  by  stimulation  of  the  spinal 
centers  from  the  first  dorsal  down,  and  vibration  along  the 
entire  course  of  the  nerve. 

Relaxation  of  the  tissues  about  the  sciatic  notch  is  abso- 
lutely necessary.  In  chronic  cases  of  sciatica  the  wave  current, 
localized  over  the  nerve  exit  and  over  the  sciatic  notch,  is  very 
effective.  Long  sparks  applied  over  the  nerve  track  fre- 
quently give  great  relief.  Although  cases  are  often  cured 
in  a  short  time,  many  cases  call  for  patient  continuance  of 
treatment.  Deep  vibratory  pressure  by  hand  just  above  the 
thigh  in  the  iliac  fossa  is  frequently  followed  by  instant  relief, 
when  all  other  methods  fail. 

In  acute  cases  of  neuralgia  a  hot  static  spray  over  the 
origin  of  the  nerve,  static  brush  discharge,  and  the  high  fre- 
quency current  over  the  course  of  the  nerve  for  twenty  to 
thirty  minutes,  as  well  as  applications  of  Leyden  jar  currents, 


246  PRACTICAL   ELECTRO-THERAPEUTICS. 

are  very  effective,  though  it  must  be  remembered  that  almost 
any  kind  of  electricity  may  aggravate  the  symptoms  at  first 
treatment. 

Exposure  of  the  painful  parts  to  the  X-rays  will  frequently 
be  followed  by  immediate  and  wonderful  relief  in  otherwise 
stubborn  cases  of  neuralgia.  If  the  neuralgia  is  of  a  toxic 
nature,  electric  light  baths  are  indicated. 

Intercostal  neuralgia  is  frequently  relieved  by  counterirri- 
tants.  It  is  on  this  account  that  the  static  spray  is  very 
effective.  The  faradic  brush  frequently  acts  very  favorably. 


Applying  High  Frequency  Current  by  Means  of  Hand. 

and  galvanism  will  often  relieve  promptly  and  permanently. 
The  positive  pole  is  usually  placed  over  the  vertebrae,  and  the 
cathode,  or  negative  pole,  near  the  sternum,  or  vice  versa. 
The  pain  is  usually  relieved  by  the  first  galvanization. 

Coccygodinia  is  due  in  most  cases  to  either  an  arthritis  or  a 
neuritis.  Static  modalities  seem  to  be  successful  in  almost 
every  case  where  the  treatment  is  continued.  The  prognosis 
is  generally  good  unless  inflammatory  products  deposited 
restrict  motion.  The  wave  current  or  sparks  are  indicated 
to  promote  the  reabsorption  of  the  products  of  inflammation. 

Exophthalmic  Goiter. — This  form  of  neurosis  is  undoubt- 


PRACTICAL    ELECTRO-THERAPEUTICS.  247 

edly  greatly  benefited  by  means  of  the  galvanic  current.  That 
it  is  entirely  cured  by  electricity  alone  is  very  improbable. 
The  positive  pole  is  placed  at  the  nape  of  the  neck,  the 
center  of  its  lower  border  corresponding  with  the  seventh  cer- 
vical spinous  process.  The  negative  electrode  should  be 
moved  up  and  down  the  side  of  the  neck  from  the  mastoid 
process  along  the  course  of  the  great  occipital  nerve.  Several 
applications  a  day  of  a  weak  current  (two  milliamperes) 
for  five  minutes  to  ten  minutes  give  marked  relief  to  the 
patient.  Treatment  may  be  applied  by  patient,  as  it  is  in- 
convenient for  a  physician  to  treat  a  patient  that  many 
times  a  day. 

Chorea. — This  disease  does  not  seem  to  be  favorably  influ- 
enced by  any  form  of  electricity,  while  vibratory  stimulation 
over  the  entire  spine  and  over  the  sides  of  the  neck  seems  to 
have  a  very  soothing  influence  upon  the  patient.  Flushing 
the  lower  bowels  and  dilating  the  sphincter  have  been  most 
effective  in  the  author's  practice  in  connection  with  medi- 
cinal treatment. 

Epilepsy. — Unless  due  to  heredity  or  brain  lesion,  a  fair 
percentage  of  cases  get  well  under  proper  treatment.  In 
these  cases  the  cause  is  usually  found  in  some  lesion  which 
interferes  with  the  nutrition  of  the  cord  or  brain,  or  irri 
tation  of  the  motor  nerve-strands  running  to  the  periph- 
eral motor  structures,  exciting  the  connected  nerves,  or  an 
auto-intoxication  due  to  the  obstruction  of  lymph  and 
venous  circulation.  The  exciting  cause  may  be  in  the  intes- 
tines, and  diet  must  be  carefully  regulated. 

Treatment — Stimulate  the  spinal  centers  in  the  cervical 
region  as  well  as  those  from  the  middle  dorsal  'to  the  last 
lumbar  region,  by  means  of  vibration,  and  give  the  wave 
current  to  the  upper  spine,  and  the  spray  over  the  solar 
plexus  daily.  If  due  to  auto-infection  a  hot  air  or  electric 
light  bath  will  be  a  great  aid. 

Static  electricity  may  be  applied  for  its  tonic  effect  and 
for  relief  of  nervous  irritability. 

Hysteria,  being  a  functional  disease  of  the  nervous  system, 
is  frequently  found  to  depend  on  some  lesion  which  disturbs 
the  nervous  equilibrium.  There  is  usually  some  actual 
derangement  responsible  for  the  altered  conditions  in  those 
of  neurotic  temperament. 

Treatment — Stimulation  of  the  entire  spine,  especially  the 


248  PRACTICAL    ELKCTRO-TIIEKAI'KUTICS. 

dorsal  and  sacral  regions;  friction  sparks  to  entire  body; 
sedative  spray  over  pelvic  organs;  wave  current  with 
electrode  applied  to  lower  spine  to  correct  circulation  in 
the  colon,  intestines  and  genitals.  Stretching  of  the  sphincter 
muscle  was  followed  by  relief  in  a  number  of  the  author's 
cases. 

All  the  numerous  occupation  neuroses,  such  as  those  of 
musicians,  telegraphers,  seamstresses,  barbers,  drivers,  milk- 
ers, cigarmakers,  penmen,  etc.,  are  in  reality  starvation 
neuroses  and  manifestations  of  a  more  or  less  severe  obstruc- 
tion of  nerve  supply.  The  occupation  which  brings  about 
these  conditions  usually  requires  the  elevation  of  the  right 
shoulder,  resulting  in  drawing  the  upper  ribs  together  and 
approximating  the  clavicle  and  first  rib  in  such  a  manner 
as  to  bring  pressure  to  bear  upon  the  brachial  plexus. 

Treatment  consists  in  stimulating  the  vaso-motor  secretory 
and  trophic  centers  involved  by  means  of  mechanical  vibra- 
tions, and  making  a  liberal  application  of  short  sparks  to  the 
ball  of  the  thumb,  muscles  of  the  forearm,  neck  and  cervical 
spine,  followed  by  friction  sparks.  Always  relieve  the 
obstruction  or  the  pressure  on  the  nerve.  In  stubborn 
cases  the  arm  may  be  placed  in  a  water  bath  and  treated  in 
this  way  by  means  of  the  wave  current. 

Counterirritation  by  means  of  the  static  spray  or  high 
frequency  application  over  the  clothes  will  remove  the  weary, 
tired  feeling. 

Locomotor  Ata.via. — In  this  trouble  the  electrical  examina- 
tion of  common  sensation  is  of  special  interest  and  value. 
The  sensibility  of  the  whole  surface  of  the  body  will  often  be 
found  to  be  very  much  decreased.  The  sensibility  is  usually 
affected  in  proportion  to  the  general  sensibility,  but  in  certain 
cases  there  will  be  absolute  and  complete  analgesia  to  the 
strongest  current.  In  unilateral  affections  the"  difference  in 
farado-cutaneous  sensibility  can  often  be  clearly  brought  out. 

Aconite  applied  by  means  of  cataphoresis  frequently  gives 
relief  for  the  dorsal  neuralgic  pains  in  locomotor  ataxia. 

Application  must  be  made  for  five  or  ten  minutes,  and 
eight  to  ten  drops  may  be  applied  at  one  treatment,  with  a 
current  strength  of  five  or  six  milliampcres. 

The  absorption  of  toxines  from  the  bowels  usually  aggra- 
vates the  dorsal  pains,  hence  colonic  flushings  must  not  be 
neglected  while  receiving  electric  treatments. 


PRACTICAL    ELECTRO-THERAPEUTICS.  249 

Bladder  pains  of  locomotor  ataxia  may  be  greatly  relieved 
by  systematic  application  once  a  day  of  the  fine  wire  faradic 
current  through  the  parts  affected,  the  negative  pole  being 
applied  over  the  sacrum  and  the  positive  pole  over  the  sym- 
physis,  and  the  gradual  increase  of  strength  with  the  fine 
interruptions  until  the  limit  of  pleasant  toleration  is  reached. 
Application  should  be  from  ten  to  twenty  minutes. 

There  can  be  no  doubt  as  to  the  beneficial  effect  of  elec- 
tricity in  this  affection.  The  important  symptoms  may  be 
caused  to  disappear  and  the  patient  made  comparatively 
comfortable  during  the  initial  and  ataxic  stages  of  this 
disease.  As  a  chronic  disease  it  demands  chronic  treatment. 
Treatment  should  be  galvanization  with  a  moderate  current 
strength  of  two  milliamperes  to  a  square  inch  for  ten  to 
twenty  minutes  daily,  with  the  electrodes  over  the  nerve 
extremities,  one  at  the  nape  of  the  neck  and  the  other  one  on 
the  lumbar  region,  or  one  electrode  may  be  placed  on  the 
sternum,  while  the  other  one  is  applied  to  the  spine. 

It  is  important  not  to  neglect  the  treatment  of  the  nerve 
roots  and  the  peripheral  nerves,  since  they,  as  well  as  the 
posterior  column  of  the  cord,  are  in  many  instances  the  seat 
of  pathological  change. 

When  patients  under  galvanic  and  faradic  treatment  fail 
to  show  improvement,  recourse  should  be  had  to  static 
electricity,  as  under  this  treatment  improvement  frequently 
results  almost  immediately  when  other  currents  have  failed. 
Thick  percussive  sparks,  from  four  to  eight  inches  in  length, 
should  be  administered  over  the  spine  to  the  nerve  roots 
and  trunks,  to  peristethic  areas  and  to  all  points  from  which 
ingoing  impressions  may  be  caused  to  impinge  upon  the 
spinal  gray  matter,  or  to  affect  the  spinal  circulatory  mech- 
anism. The  density  of  the  charge  from  a  static  machine  is 
likewise  sufficient  to  afford  a  powerful  rubefacient  effect  to 
the  cutaneous  nerve  distribution.. 

The  wave  current  from  the  static  machine  with  the 
electrode  on  the  spine  (treatment  thirty  minutes  daily)  has 
in  the  author's  experience  been  most  effective  in  relieving 
pains  of  ataxia. 

Insomnia  is  only  a  symptom  of  some  underlying  patho- 
logical condition,  and  whether  this  condition  be  due  to  infec- 
tion or  auto-intoxication,  it  must  be  remembered  that  there 
are  always  a  number  of  cerebral  cells  in  an  unusual  state  of 


250  PRACTICAL    ELECTRO-THERAPEUTICS. 

vigilance  while  they  should  be  in  repose.  This  perverted 
cerebral  circulation  must  be  corrected  before  the  cells  can 
perform  their  normal  functions. 

While  receiving  the  static  breeze,  patients  suffering  from 
insomnia  often  fall  into  a  refreshing  physiological  sleep,  due 
to  lowered  arterial  tension,  which  in  turn  is  followed  by 
lowered  frequency  of  the  heart's  action  and  increased  volume 
of  pulse.  Internal  congestion  and  strain  upon  the  heart 


Galvanic  Current  in  Megrim. 

muscle  are  relieved  by  dilatation  of  the  integumental  blood- 
vessels. This  lowered  tension  in  the  blood-vessels  also  has 
the  effect  of  aiding  respiration,  which  becomes  less  labored, 
less  frequent  and  deeper.  As  a  sedative  to  the  nervous 
system  static  electricity  surpasses  the  hypnotic  and  sedative 
drugs  by  inducing  a  return  to  normal  sleep,  and  assures  it 
popularity  wherever  its  uses  are  known. 

Vibration  over  both  sides  of  the  neck,  as  well  as  stimula- 
tion of  centers  in  spine  from  seventh  dorsal  up;  hot  static 
spray  over  the  spine,  liver  and  solar  plexus;  wave  current 


PRACTICAL    ELECTRO-THERAPEUTICS.  251 

over  the  liver,  and  electric  light  or  hot  air  baths,  are  all 
agents  that  tend  to  correct  or  combat  the  underlying 
pathological  condition. 

When  static  methods  fail,  try  central  galvanization;  it  may 
prove  itself  more  efficacious. 

After  applying  the  current  for  one  to  two  minutes  over 
the  vertex,  move  it  over  the  sterno-cleido-mastoid  muscle, 
the  object  being  to  influence  the  pneumogastric  nerves. 
Make  application  on  both  sides  of  the  neck.  Then  apply  the 
current  to  the  entire  length  of  the  spine. 

Avoid  interruptions  most  studiously.  Observe  the  effect 
on  pulse  and  respiration.  If  more  than  two  milliamperes 
are  used  move  the  negative  electrode  about  in  order  to  pre- 
vent electrolytic  action.  The  positive  pole  is  usually  the 
active  one,  because  the  indications  for  general  galvanization 
usually  call  for  tonic  sedative  effects. 

In  the  treatment  of  this  chronic  and  obstinate  symptom, 
general  faradization  should  never  be  forgotten.  It  increases 
the  nutrition  of  brain  and  spinal  cord,  sends  richer  blood 
to  a  fatigued  and  exhausted  stomach,  increases  peristalsis 
of  the  intestines  and  relieves  constipation. 

The  liver  and  spleen  acted  on  by  the  alternating  currents 
applied  locally  may  be  made  to  exercise  their  specific  action 
on  the  intrapelvic  organs  without  use  of  the  internal  electrode. 
The  effect  is  dependent  on  electromotive  force  and  on  the 
smoothness  and  the  number  of  interruptions. 

In  paralysis  of  the  diaphragm  the  galvanic  current  should 
be  used,  the  positive  pole  against  the  outer  border  of.  sterno- 
cleido-mastoid  muscle,  the  negative  pole  upon  the  epigas- 
trium. In  a  case  of  laudanum  poisoning  the  galvanic  cur- 
rent may  have  to  be  applied  for  hours,  until  the  respiration 
has  risen  to  about  twenty  per  minute  and  the  contracted 
pupils  have  become  dilated. 

In  chloroform  narcosis  the  galvanic  current,  passed 
through  the  phrenic  nerve,  has  been  successful  in  some 
cases. 

We  are  told,  however,  that  there  is  danger  of  stimulating 
the  vagus  at  the  same  time  that  we  stimulate  the  phrenic 
nerve.  This  stimulation  of  the  vagus  would  readily  arrest 
the  action  of  an  already  failing  heart.  Therefore,  to  avoid 
reaching  the  vagus,  electrolization  of  the  phrenic  nerve  must^  \\\\ 
be  reserved  as  a  last  resort.  In  ether,  opium  or  aconite 

N 


252  PRACTICAL   ELECTRO-THERAPEUTICS. 

poisoning  it  is  safe  to  try  to  stimulate  the  phrenic  nerve, 
because  in  the  first  case  the  heart  is  not  depressed,  and  in 
the  second  case  the  heart's  action  is  rapid  and  feeble,  and  it 
is  desired,  if  possible,  to  exercise  some  inhibitory  action.  In 
the  third  case,  the  pneumogastric  nerve  is  paralyzed  and 
would  not  respond  to  electricity. 

Faradization  of  the  thorax  is  frequently  followed  by 
increased  respiratory  efforts,  and  is  frequently  used  in  the 
same  conditions  in  which  inhalations  of  oxygen  are  now 
generally  employed  with  advantage.  The  stimulation  must 
be  addressed  to  the  nervous  mechanism,  which  controls  the 
respiratory  act. 

Lead  Paralysis. — The  distribution  of  the  paralytic  effects 
of  chronic  lead  poison  varies  greatly.  Static  sparks  to  the 
spine  and  muscular  surface  of  the  trunk  and  extremities  are 
a  great  aid  in  assisting  other  methods  of  elimination.  \Yhen 
atrophy  has  taken  place  local  applications  of  the  faradic  and 
Leyden  jar  currents  are  indicated.  Painters  having  slight 
attacks  respond  to  treatment  much  faster  when  with  it  are 
associated  various  static  modalities. 


DISEASES  OF  THE  ALIMENTARY  TRACT. 

In  spasmodic  stricture  of  the  esophagus,  which  is  usually 
associated  with  the  neurasthenic  state,  hysteria,  etc.,  elec- 
tricity may  be  applied  for  the  purpose  of  reducing  reflex 
excitability.  The  galvanic  current  is  to  be  preferred.  The 
negative  pole  may  be  placed  on  the  back  of  the  neck  over 
the  cilio-spinal  center,  while  the  positive  is  held  just  over 
the  sternum  or  over  the  border  of  the  sterno-cleido-mastoid 
muscle.  If  this  fails  an  insulated  esophageal  electrode, 
with  a  metal  tip,  should  be  introduced  in  the  esophagus  to 
the  point  of  spasm.  Great  caution  must  be  exercised,  on 
account  of  the  proximity  of  the  pneumogastric  nerve.  The 
faradic  current  may  also  be  used,  applied  to  the  constrictor 
muscles  of  the  pharynx,  and  is  sometimes  very  effective. 

In  stricture  of  the  esophagus  cathodal  electrolysis  with 
a  current  of  ten  or  fifteen  milliamperes  may  be  used,  treat- 
ment lasting  from  three  to  twenty  minutes.  The  electrode 
must  be  more  flexible  than  the  ordinary  esophageal  bougie 
made  for  gradual  dilatation. 

Hiccoughs  are  undoubtedly  of  a  reflex  origin.  Galvaniza- 
tion and  faradization  of  the  phrenic  nerve  have  been  resorted 
to  with  marked  success.  The  treatment  is  the  same  as  that 
for  paralysis  of  the  diaphragm. 

Vibratory  stimulation  to  the  spine  has  been  successful, 
following  one  treatment,  where  the  various  other  forms  of 
electricity  and  drugs  were  unsuccessful. 

Firm  pressure  on  the  phrenic  nerves  for  a  few  minutes 
will  sometimes  relieve  an  obstinate  case  of  hiccough  in  a  few 
minutes. 

Hyperesthesia  of  the  Stomach  and  Vomiting. — These 
symptoms  are  frequently  an  expression  of  a  neurotic  condi- 
tion, rather  than  of  a  gastric  disease.  If  of  a  purely  neurotic 
origin,  there  is  usually  no  nausea  present.  Electricity,  as  a 
rule,  greatly  benefits  these  cases  and  general  faradization  and 
galvanism  are  frequently  very  effective. 

In  atony  of  the  stomach  the  integrity  of  the  digestive 
powers  depends  on  the  tone  of  the  muscular  tissues  of  the 
stomach,  as  well  as  upon  the  healthy  action  of  the  nerves  and 

253 


254  PRACTICAL    ELECTRO-THERAPEUTICS. 

nerve  centers.  Indigestion  in  many  cases  depends  upon 
deficient  gastric  secretions  rather  than  on  lack  of  muscular 
tone.  Lack  of  muscular  tone  develops  gradually.  Indiges- 
tion due  to  atony  causes  no  pain,  while  epigastric  tenderness 
is  almost  invariably  associated  with  an  inflamed  condition  of 
the  mucous  membrane.  Many  cases  improve  rapidly  under 
electricity  when  used  in  connection  with  other  proper  hygienic 
measures.  The  tendency  of  electricity  is  to  increase  secretory 
processes  and  modify  their  quality. 

The  appetite  is  sharpened,  digestion  is  quickened,  constipa- 
tion relieved. 

Patients  in  whom  hydrochloric  acid  was  absent  after  a 
test  meal  frequently  showed  hydrochloric  acid  after  internal 
faradization. 

An  excellent  means  of  studying  the  variation  of  nutrition 
through  electricity  is  found  in  the  examination  of  urine. 
This  is  believed  to  be  a  result  of  oxidation,  taking  place 


CEsophageal  Electrode. 

either  in  the  kidneys,  in  the  tissues,  or  in  both.  There  is 
no  single  chemical  change  which  explains  growth  and 
sustenance  of  the  body.  Electricity  passing  through  the 
body  modifies  many  of  these  processes.  Animal  nutrition 
is  a  process  of  enormous  complication.  In  applying  the 
faradic  current  the  electrode  should  be  sufficiently  large 
to  prevent  any  undue  concentration  of  current,  and  the  elec- 
trode over  the  region  of  the  stomach  should  be  kept  in  almost 
constant  motion.  The  rapidly  interrupted  galvanic  current 
is  also  of  value  in  these  cases,  though  inferior  to  the  other 
currents.  The  peristaltic  movements  of  the  stomach  depend 
upon  the  integrity  of  the  vagus  nerve,  and  anything  that 
interferes  with  its  accelerating  influence  interferes  with 
peristalsis. 

In  the  author's  hands  the  high  frequency  current  applied 
to  the  region  of  the  solar  plexus  by  means  of  the  glass  elec- 
trode has  been  a  most  effective  measure  in  these  cases, 


PRACTICAL    ELECTRO-THERAPEUTICS. 


255 


improvement  being  noticeable  in  a  very  short  time.  This  is 
especially  true  in  infants  where,  due  to  the  distended  condi- 
tion of  the  intestines,  we  practically  find  an  immovable  dia- 
phragm. This  effect  on  the  respiratory  organs  produces  a 
condition  of  insufficient  oxidation  and  when  we  realize  that 
every  chemical  change  in  the  body  is  one  of  oxygen  we  see 
why  this  current  with  its  abundance  of  oxygen  applied 
directly  to  the  parts  is  so  effective.  Gastro-enteric  infec- 
tions also  show  a  marked  improvement  under  this  treatment, 
and  make  a  much  more  rapid  recovery  than  ordinarily. 


High-Frequency  Current  in  Atonic  Dilatation  of  the  Stomach. 

In  treating  gastric  dilatation  Einhorn's  electrode  is  used, 
and  can  be  swallowed  by  the  patient  the  same  as  a  stomach 
tube. 

All  kinds  of  electricity  affect  gastralgia  favorably,  vary- 
ing with  the  individual. 

Spasm  of  the  stomach  also  yields  to  electrical  treatment. 

In  paralysis  of  the  intestines  and  consequent  constipation, 
the  nervous  system  may  be  at  fault,  the  muscles  losing  their 
contractile  power,  due  to  enervation.  Thus,  disease  of  the 
spinal  cord  itself  may  produce  intestinal  paralysis.  Constant 
dilatation  due  to  retained  feces  may  also  cause  it.  When 


25G  PRACTICAL    ELECTRO-THERAPEUTICS. 

there  is  any  depreciation  in  the  tone  of  the  muscular  and 
nervous  systems  both  the  galvanic  and  faradic  currents  may 
be  used.  If  the  galvanic  current  is  employed  the  cathode 
(negative  pole)  should  be  placed  in  the  rectum,  the  current 
hardly  exceeding  more  than  two  or  three  milliamperes.  If 
used  with  an  interrupted  current  one  to  two  milliamperes 
are  sufficient.  The  strength  of  the  faradic  current  is  safely 
left  to  the  sense  of  the  patient.  Whatever  can  be  borne 
without  great  discomfiture  can  be  safely  used.  The  internal 
electrode  should  invariably  be  the  negative. 

Constipation  treated  by  electricity  most  often  yields 
rapidly.  To  be  successful  we  must  take  into  consideration 
all  the  causes  which  have  led  up  to  the  condition,  as  neglect- 
ing to  attend  to  nature's  calls,  sedentary  habits,  faulty  dress, 
insufficient  drinking  of  water,  etc. 

There  is  no  doubt  about  chronic  constipation  being  largely 
due  to  loss  of  sensibility  in  the  nerves  of  the  bowels  and 


Stomach  Electrode. 

rectum,  brought  about  by  the  absorption  of  toxic  materials 
from  the  bowels.  The  treatment  consequently  resolves 
itself  into  removing  the  stasis  in  the  blood  stream  of-  the 
bowels.  A  sufficient  blood  supply  in  the  vessels  of  the  bowels 
will  revive  the  poisoned  nerves  and  bring  about  normal 
secretions  in  the  bowels.  The  static  wave  current  applied 
by  means  of  a  rectal  electrode  (the  metal  tip  being  inserted 
well  above  the  sphincter  muscle)  exercises  the  intestinal 
muscles  and  brings  about  peristaltic  movements  obtained 
in  no  other  way. 

In  the  application  of  galvanic  electricity  the  positive  pole 
is  placed  over  the  liver,  while  the  negative  pole  is  moved 
slowly  in  a  rocking  motion  from  the  right  inguinal  region 
upwards  and  downwards  on  the  left  side  over  the  descend- 
ing colon,  and  repeated  several  times  in  the  same  way,  t.he 
treatment  lasting  about  twelve  minutes  with  a  current 
strength  of  from  twenty  to  twenty-five  milliamperes. 


PRACTICAL    ELECTRO-THERAPEUTICS. 


257 


Three  applications  a  week  should  be  made.  When  a  strong 
effect  is  desired,  a  rectal  electrode  covered  with  chamois  skin 
may  be  inserted  in  the  rectum,  using  a  current  strength  of 
about  ten  milliamperes.  The  treatment  should  be  continued 
for  about  ten  minutes. 

Chronic  diarrhea  is  favorably  influenced  by  general 
faradization.  Combined  with  frequent  and  prolonged 
applications  to  the  abdomen  and  back,  general  faradization 
seems  to  have  not  only  a  direct  local  effect  upon  the  affected 
parts  themselves,  but  a  most  invigorating  influence  upon  the 
system  at  large. 

In  prolapsus  ani  apply  faradic  current,  high  tension,  with 
the  positive  pole  at  the  prolapsed  part  and  the  negative  pole 
over  the  abdomen,  the  current  adjusted  to  the  tolerance  of 
the  patient.  Treatment  should  be  made  three  times  a  week. 


Rectal  Electrodes  for  Static  Wave  Current. 

Hemorrhoids  are  usually  caused  by  an  impediment  to  the 
return  of  venous  blood  from  the  hemorrhoidal  veins,  and 
are  as  a  rule  accompanied  by  constipation.  The  cause  of 
this  -interference  may  be  found  in  any  of  the  areas  of  the 
spine  that  regulate  the  circulation  and  muscular  tone  of 
the  abdominal  and  pelvic  viscera,  and  obstruct  portal 
circulation. 

Many  severe  cases  have  been  treated  by  vibration  of  the 
lower  spinal  centers  and  the  solar  plexus.  The  high 
frequency  current,  applied  to  the  rectum  by  means  of  a  glass 
electrode,  usually  relieves  a  good  deal  of  local  congestion 
at  the  first  treatment.  The  active  cause  of  the  trouble 
(constipation)  can  frequently  be  reached  by  means  of  the  . 
static  wave  current  applied  by  means  of  a  rectal  electrode. 
A  spark-gap  of  at  least  four  inches  should  be  employed. 

17 


258  PRACTICAL   ELECTRO-THERAPEUTICS. 

This  produces  a  powerful  massage  which  affects  the  entire 
alimentary  canal.  The  swelling  method  with  variations 
may  also  be  used  with  success. 

The  positive  pole  of  the  galvanic  current  applied  by  means 
of  a  chamois-covered  copper  electrode,  is  very  effective  in 
the  treatment  of  recent  cases.  On  account  of  its  vaso-con- 
strictor  qualities  the  turgescence  of  the  lower  bowel  rapidly 
subsides.  It  not  only  relieves  the  inflammation  but  the  pain 
as  well.  The  electrode  may  be  lubricated  with  a  ten  per 
cent,  solution  of  ichthyol  in  glycerine.  A  current  of  ten  to 
fifteen  milliamperes  applied  for  ten  minutes  every  third  day 
is  usually  sufficient  to  secure  the  desired  result. 

Old  and  hard  external  hemorrhoids  may  be  removed  by 
negative  electrolysis. 

Fissures. — High  frequency  currents  affect  some  cases 
favorably.  •  When  this  form  of  treatment  is  effective, 
improvement  will  be  noticed  after  two  or  three  treatments. 

Fissures  are  also  readily  treated  with  a  silver  probe  used 
on  the  cathode  (negative)  pole  to  lightby  cauterize  the  raw 
surfaces  with  a  current  of  three  to  ten  milliamperes.  \Yhen 
a  copper  wire  is  used  as  the  anode  (positive  pole),  the  treat- 
ment should  continue  until  the  tissues  are  stained  green  with, 
the  dissolved  copper.  The  current  is  then  reversed  for  a 
few  seconds  until  the  wire  is  free. 

In  stricture  of  the  rectum  electrolysis  will  frequently  keep 
the  intestines  patent  as  long  as  the  malignant  disease  allows 
the  patient  to  live.  A  treatment  lasting  from  one  to  twenty 
minutes,  with  a  current  of  five  to  twenty  milliamperes, 
according  to  seat  and  nature  of  the  trouble,  and  repeated  in 
one  or  two  weeks,  is  recommended. 


RESPIRATORY  TRACT. 

In  hypertrophic  rhinitis  rapid  and  surprising  results  may 
be  obtained  by  the  use  of  the  galvanic  current.  A  copper 
wire  applicator,  covered  with  gauze  saturated  with  adrenalin 
chloroform,  allows  us  to  obtain  not  only  the  vaso-constrictor 
effect  of  the  positive  pole,  but  the  effect  of  the  adrenalin  and 
copper  cataphoresis  as  well.  A  current  of  from  three  to 
five  milliamperes  may  be  used  for  five  minutes.  Treatments 
may  be  repeated  three  times  a  week. 

In  atrophic  rhinitis,  aside  from  constitutional  treatment  and 
attention  to  hygienic  measures,  local  applications  of  the 
galvanic  current  by  means  of  the  negative  electrode  with 
one  milliampere  current,  repeated  three  times  a  week,  have 
given  favorable  results  in  cases  in  which  the  atrophy  had 
not  advanced  too  far. 

In  fetid  atrophic  rhinitis  cupric  electrolysis  has  brought 
about  cures  where  all  other  methods  failed.  After  thoroughly 
cleansing  the  parts  they  should  be  anesthetized  with  a  cocaine 
solution.  A  copper  electrode  attached  to  the  positive  pole  is 
inserted  well  into  the  tissues  of  either  middle  turbinal.  A 
current  of  from  five  to  ten  milliamperes  is  applied  and 
continued  from  three  to  ten  minutes.  A  new  needle  must 
be  used  at  each  treatment,  as  electrolysis  roughens  the  surface 
of  the  needle.  Should  the  needle  adhere,  reverse  its  polarity 
by  means  of  a  pole  changer  and  apply  a  current  of  two 
milliamperes  for  about  two  minutes.  The  results  of  this 
treatment  favor  the  theory  of  the  bacterial  origin  of  this  dis- 
ease. 

Diseases  of  the  Ear. — Tinnitus  aurium  is  frequently 
amenable  to  electrical  treatment.  If  either  the  anode  or  the 
cathode  modifies  or  arrests  the  sound  during  application  of 
the  current,  the  prognosis  is  favorable  and  treatment  should 
be  continued. 

The  ear  electrode  covered  with  moist  cotton  is  placed  over 
the  external  canal  of  the  ear;  the  resistance  between  the 
electrode  and  the  skin  should  be  reduced  as  much  as  possible. 
The  non-active  electrode  may  be  placed  on  any  spot  not  in 
transverse  direction  from  the  ear  undergoing  treatment. 

259 


260  PRACTICAL   ELECTRO-THERAPEUTICS. 

Begin  the  current  at  zero  and  creep  up  at  a  snail's  pace. 
At  the  first  report  of  faintness  or  nausea  stop.  An  increase 
of  one  milliampere  per  minute  and  a  decrease  at  the  same 
rate  is  not  too  slow  for  correct  technique.  Don't  break 
contact  during  the  application  of  the  current. 

In  tonsillitis  of  a  chronic  nature  a  compressed  loop  of 
platinum,  heated  to  redness,  may  be  plunged  into  the  mouths 
of  distended  crypts.  Pierce  the  surface  at  three  or  four 
points  at  each  sitting.  The  operation  should  be  repeated 
once  or  twice  a  week. 

Obstructions  of  the  anterior  nasal  passages  may  be  suc- 
cessfully removed  or  relieved  by  the  galvano-caustic  loop. 
Pain  is  usually  relieved  by  the  application  of  cocaine. 

In  tracheotomy  the  galvano-caustic  method  has  been 
employed  by  passing  a  curved  needle,  carrying  a  double 
platinum  thread,  into  the  trachea,  directly  through  the  skin 
and  other  superjacent  structures,  and  then  emerging  about 


Ear   Electrode. 

two  centimeters  above  the  point  of  entrance.  The  two  ends 
were  then  connected  to  the  two  ends  of  a  galvanic  pile  and 
the  intermediate  loop  heated  by  a  current  and  drawn  through 
the  entire  mass  of  intervening  tissue.  The  entire  operation, 
as  a  rule,  does  not  cost  a  drop  of  blood,  thus  showing  its 
advantages  over  a  cutting  operation  in  edema  of  the  glottis, 
neoplasmus,  etc.,  where  hemorrhage  is  liable  to  be  an  alarm- 
ing feature.  The  platinum  loop  may  be  used  for  the  removal 
of  hypertrophied  tonsils,  but  had  best  be  reserved  for  excep- 
tional cases,  where  hemorrhage  is  threatened  on  account  of 
vascular  anomalies  or  hemorrhagic  diathesis. 

Tubercular  Laryngitis. — In  this  trouble  cupric  electrolysis 
applied  by  means  of  a  laryngeal  electrode  to  which  a  small 
bulb  of  chemically  pure  copper  is  attached  has  been  recom- 
mended. The  bulb  is  applied  directly  to  the  diseased  area 
under  full  illumination  from  the  laryngeal  mirror.  The 
larynx  should  first  be  anesthetized  with  a  cocaine  solution. 
The  copper  electrode  is  connected  with  the  positive  pole, 


PRACTICAL    ELECTRO-THERAPEUTICS. 


261 


the  dispersing  electrode  being  applied  to  the  neck.  From 
one  to  three  milliamperes  should  be  used  for  five  minutes  at 
each  sitting.  The  application  may  be  repeated  every  second 
day.  There  is  no  real  destruction  of  tissue  under  this  treat- 
ment and  no  lacerations  of  any  surface  which  might  form 
a  point  of  entrance  for  new  germs,  as  is  the  case  with  curette- 
ment  and  cautery.  The  cure  is  effected  by  the  healthy  reac- 
tion of  the  tissues,  in  the  same  manner  in  which  we  often 
see  specific  lesions  heal  when  the  system  is  under  the  influence 
of  mercuries. 

Asthma. — The  exciting  causes  of  asthma  are  numerous, 
and  the  disease  varies  with  the  source  of  irritation.  Both 
faradic  and  static  electric  currents  have  been  used  in  various 
ways,  and  while  successful  in  some  cases,  in  many  more 
they  have  failed.  The  electrodes  should  be  placed  on  opposite 


Cautery  Snare  and  Cautery  Electrode  Handles. 

sides  of  the  neck  at  points  from  the  angle  of  the  jaw  to  near 
the  sternum.  The  current  should  be  a  strong  one  and  used 
for  one-quarter  to  one-half  an  hour.  It  may  be  passed  from 
the  nape  of  the  neck  through  the  cardiac  region.  When  the 
faradic  current  fails  the  galvanic  should  be  tried.  Galvaniza- 
tion of  the  pneumogastric  has  been  successful.  Sometimes 
the  positive  pole  and  sometimes  the  negative  is  placed  over 
the  nerve;  that  is,  about  the  middle  of  the  outer  edge  of  the 
sterno-cleido-mastoid  muscle.  Weak  currents  should  be 
used  at  first.  Another  mode  of  treatment  has  been  to  place 
the  negative  electrode  over  the  sacrum  and  the  positive  over 
the  spine  for  ten  to  twenty  minutes  at  a  time,  or  the  electrodes 
may  be  placed  on  opposite  sides  of  the  thyroid  cartilage. 
The  various  points  should  be  tried  until  it  is  learned  which 
treatment  is  followed  by  relaxation. 


263  PRACTICAL    ELECTRO-THERAPEUTICS. 

Angina  Pectoris. — In  this  condition  galvanism  promises 
more  than  medicine  and  frequently  gives  prompt  relief ,  while 
persistent  use  of  electricity  frequently  appears  to  produce 
a  permanent  cure.  The  current  may  be  applied  in  several 
ways.  The  positive  pole,  placed  with  the  broad  surface 
over  the  heart  and  sternum,  and  the  negative  to  the  lower 
cervical  vertebra,  or  the  positive  electrode  may  be  placed  in. 
the  supra-sterno  fossa  and  the  negative  upon  the  cervical 
sympathetical  ganglion,  first  on  one  side  and  then  on  the 
other.  The  positive  pole  may  then  be  moved  to  the  lower 
cervical  ganglion  and  the  negative  pole  applied  to  the 
sensitive  spots  at  the  angles  on  both  shoulder  blades. 

Asphyxia  has  been  treated  by  electricity  with  a  few 
brilliant  results,  but  with  more  failures. 

The  faradic  current  should  be  used  and  applied  by  means 
of  a  large  sponge  electrode  to  the  phrenic  nerve  along  the 
insertion  of  the  diaphragm  into  the  thorax  wall.  The  cur- 
rent first  used  should  be  strong  enough  to  contract  the 
muscles  of  the  thumb  vigorously.  The  current  should  be 
interrupted  as  often  as  three  times  a  minute,  audits  strength 
can  gradually  be  increased.  If  the  faradic  current  fails,  try 
the  galvanic,  though  it  is  less  frequently  successful  in 
reestablishing  respiration.  Place  the  positive  pole  over  the 
epigastrium  or  along  the  attachment  of  the  diaphragm  with 
the  ribs,  and  the  negative  on  the  phrenic  nerve,  that  is, 
along  the  outer  edge  of  the  sterno-cleido-mastoid  muscle 
just  below  its  middle.  Or,  instead  of  this,  the  current  may 
be  passed  transversely  through  the  body  at  the  horizon  of 
the  diaphragm.  The  current  should  be  moderately  strong. 
It  can  be  conceived  that  a  strong  current  might  stop  the 
heart  when  feebly  beating. 

Coughing  can  be  provoked  by  passing  a  galvanic  current 
from  a  negative  electrode  at  the  nape  of  the  neck  to  the 
positive  electrode  on  the  dorsal  vertebra  by  breaking  or 
reversing  the  current.  By  this  procedure  tickling  in  the 
throat  and  coughing  are  excited. 

The  pneumogastric  nerve  can  be  galvanized  by  applying 
one  electrode  along  the  external  border  of  the  sterno-cleido- 
mastoid  muscle  a  little  below  its  middle  and  the  other  over 
the  heart.  In  this  way  a  rapid  heart  can  be  slowed  to 
much  uniformity. 

The  faradic  current  may  be  applied  to  the  same  point  on 


PRACTICAL    ELECTRO-THERAPEUTICS.  263 

the  neck  and  over  the  cartilage  of  the  seventh  rib,  or  to 
other  points  where  the  diaphragm  is  inserted  into  the  thorax, 
in  order  to  stimulate  a  paralyzed  diaphragm. 

This  treatment  is  also  applicable  to  chloroform,  opium 
and  other  drug  narcosis  and  to  drowning. 

The  author  suggests  that  patients  suffering  from  opium 
narcosis  when  brought  to  hospital  be  placed  on  the  platform 
of  a  static  machine,  as  sparks  repeatedly  applied  are  a 
stimulant  that  reach  the  vital  centers  as  no  other  measure  at 
our  disposal. 


PELVIC  ORGANS. 

Suppression  of  menses,  dysmenorrhea,  leucorrhea,  prolapse 
of  the  uterus,  etc.,  are  all  due  more  or  less  to  faulty  nutri- 
tion and  circulation  in  the  pelvis  and  can  be  relieved  and 
improved  only  by  removing  the  cause,  which  is  frequently 
found  in  the  obstructed  and  enlarged  lymph  vessels  and  venous 
circulation. 

Electrical  treatment  as  well  as  vibratory  stimulation  have 
both  scored  a  decided  success  in  the  treatment  of  pelvic 
disorders,  and  in  no  place  in  the  whole  art  of  healing  do 
patience  and  care  accomplish  as  much  as  in  the  treatment  of 
chronic  pelvic  disorders. 

The  more  we  know  of  electricity  the  more  we  hesitate  in 
hurrying  our  patients  to  the  operating  room,  as  electricity 
lacks  the  horror  of  an  operation  as  well  as  the  dangers  of 
an  anesthetic.  Both  faradic  and  galvanic  currents  are  used. 

The  faradic  current  is  a  valuable  stimulant  to  contrac- 
tions and  physiological  exercise  of  the  uterus.  It  restores 
tone  to  the  impaired  muscle  structure  in  the  pelvis,  as  found 
in  the  relaxed  uterus  of  subinvolution  and  weakened  states  of 
certain  muscular  and  fibre-muscular  structures  of  the  uterus, 
vagina  and  uterine  supports. 

In  making  pelvic  applications  of  electricity  have  the  patient 
assume  the  recumbent  position,  loosen  the  clothing  and  see 
that  both  the  bladder  and  colon  are  empty.  The  electrode 
should  always  be  warmed,  and  then  anointed  with  glycerine 
or  soap  so  as  to  facilitate  its  insertion.  It  must  be  introduced 
with  the  greatest  gentleness,  avoiding  contact  with  or  pres- 
sure on  tender  spots. 

The  vaginal  galvanic  applications  are  necessarily  mono- 
polar.  The  active  electrode  can  be  pressed  behind  the  exuda- 
tion or  enlarged  organs,  the  indifferent  pad  being  on  the  abdo- 
men or  back,  and  the  electrode  being  so  disposed  as  to  include 
the  diseased  portion  within  the  tract  of  the  densest  current 
line.  The  conducting  surface  of  the  electrode  should  always 
be  covered,  to  prevent  the  cauterizing  action  on  the  tissues, 
the  most  convenient  covering  being  absorbent  cotton  wound 
about  the  conducting  surface,  thoroughly  soaped  and  lubri- 

264 


PRACTICAL   ELECTRO-THERAPEUTICS.  2(55 

cated  with  non-irritating  soap,  the  cotton  being  detached 
after  each  application. 

When  it  is  desired  to  produce  a  determination  of  blood  to 
the  pelvis  or  uterus,  the  negative  pole  is  made  the  internal 
or  active  electrode.  When  the  contrary  effect  is  desired  the 
positive  pole  is  used. 

In  the  conditions  in  which  intrauterine  treatments  are 
applicable,  the  amount  of  current  strength  depends  upon 
the  idiosyncrasy  of  the  patient  as  to  pain.  It  must  be 
remembered  that  the  same  effect  can  be  obtained  from 
fifty  milliarriperes  applied  for  twenty  minutes  that  is  obtained 
from  two  hundred  milliamperes  applied  for  five  minutes.  The 
powerful  action  within  the  intrapolar  region  would,  however, 
be  lacking,  the  weaker  current  strength  merely  effecting  the 
cauterization.  Again,  the  caustic  effect  of  slowly  liberated 
chemicals  does  not  compare  with  that  delivered  en  masse. 

The    thickened    endometrium   may   be   disorganized    and 


Vaginal  Electrode. 

broken  up  by  the  caustic  action  of  the  negative  pole,  so  that 
it  easily  comes  away  in  shreds.  The  softening  action  of  tne 
current  relaxes  the  internal  os,  so  that  large  pieces  of  mem- 
brane may  escape.  Fatty  degeneration  is  hastened,  with 
consequent  softening.  Electricity  performs  slowly  without 
an  anesthetic  what  rapid  dilatation  and  curetting  accom- 
plishes in  a  short  time  with  an  anesthetic. 

If  the  electrode  is  bare  and  the  current  sufficient  to  cau- 
terize when  concentrated,  the  electrode  should  be  covered 
with  cotton,  to  somewhat  modify  the  effect.  If  simple 
positive  cauterization  is  required  the  electrode  should  be 
either  platinum  or  carbon,  as  cataphoresis  will  surely  follow 
if  a  decomposable  metal  electrode  is  used.  If"  it  is  desired 
to  insulate  the  electrode,  gum  shellac  heated  over  an  alcohol 
burner  will  give  a  smooth,  highly  insulated  covering.  The 
covering  should  be  sufficiently  thick. 

Intrauterine  applications  should  never  be  made  for 
neuralgias  or  general  conditions  of  any  character,  they 


2G6  PRACTICAL   ELECTRO-THERAPEUTICS. 

being    reserved    strictly  for   conditions    involving    organic 
changes  of  the- organ  itself. 

There  is  no  clear  relative  indication  governing  the  choice 
between  monopolar  and  bipolar  faradic  applications.  Bipolar 
methods  are  usually  most  effective  in  the  control  of  pain,  for 
which  the  finest -wire  coil  is  usually  preferable,  even  if  the 
patient  affirms  that  she  feels  nothing.  Both  poles  should  be 
wholly  within  the  cavity.  The  outer  pole  must  not  be  in  con- 
tact with  the  sensitive  vulvar  orifice,  and  pressure  on  painful 
spots  should  be  avoided.  The  current  from  the  secondary 
coils  should  be  employed  first,  as  it  is  the  most  sedative  and 
its  chief  effects  are  to  relieve  pain  and  congestion.  The  appli- 
cation must  always  be  grateful  to  the  patient  and  never 
uncomfortable,  hence  vibration  must  be  smooth.  Continue 
treatment  until  relief  and  sedation  are  produced.  In  many 
cases  it  produces  effects  like  opium.  Repeat  the  treatment 
daily  if  parts  are  very  painful.  Because  the  positive  is  the 


Vaginal  Bipolar  Faradic  Electrode. 

more  sedative,  it  is  nearly  always  made  the  internal  electrode 
of  the  bipolar,  and  is  placed  against  the  most  sensitive  point 
in  the  pelvis. 

A  large,  relaxed  and  discharging  uterus  soon  regains  tone 
and  diminishes  in  size,  while  the  endometrium  returns  to  its 
normal  condition.  Slow  interruptions  should  be  used  with 
the  coarse  wire  coil, 

The  fine  wire  coil  can  not  be  employed  in  these  conditions, 
as  a  larger  volume  of  current  is  necessary  than  can  be 
obtained  from  their  use. 

When  the  current  is  turned  on  the  electrode  should  be  held 
strictly  immovable,  as  movement  during  application  will 
bring  about  a  disturbance  of  the  effect.  Application  should 
be  from  four  to  ten  minutes  daily,  if  practicable. 

Direct  applications  in  the  uterus  are  sometimes  necessary. 
This  application  is  made  by  means  of  .the  bipolar  electrode 
inserted  into  the  cavity  of  the  uterus.  Both  pole  ter- 
minals must  be  wholly  within  the  cavity,  as  contact  with 
the  canal  or  internal  os  is  unnecessarily  painful  and  would 


PRACTICAL    ELECTRO-THERAPEUTICS. 


2G7 


be  unbearable  or  unendurable.  The  bipolar  electrodes  are 
only  employed  with  the  faradic  or  alternating  current  under 
strict  asepsis.  The  static  induced  current  may  at  times  be 
thus  employed. 

Aside  from  the  bipolar  vaginal  method,  there  are  various 
methods  of  applying  electrodes,  as  the  utero-cervical,  vagino- 
abdominal,  vagino-sacral  and  lumbar,  utero-abdominal 
and  utero-sacral  lumbar,  lumbar  hypogastric,  recto-abdom- 
inal and  recto-vaginal  applications. 

A  much  stronger  current  can  be  given  with  a  bipolar 
electrode  than  with  a  monopolar. 

In  electricity,  as  in  medicine,  dosage  is  of  primary  impor- 
tance. The  dose,  of  course,  is  variable  to  a  variety  of  circum- 
stances. When  the  interval  is  too  long  between  treatments 
the  benefit  of  the  treatment  is  lost,  hence  it  is  necessary  that 
they  reinforce  each  other  at  proper  uniform  intervals.  The 
long-continued  use  of  the  positive  pole  causes  contractions 


Vaginal  Bipolar  Electrodes. 

of  the  uterine  cavity  as  well  as  of  the  cervical  canal.  If  this 
contraction  is  too  great  a  few  treatments  of  the  negative 
pole  will  relieve  this  condition. 

The  vagina  and  uterus  are  comparatively  insensitive  to 
electric  currents,  and  much  stronger  currents  can  be  used 
than  on  skin. 

It  may  be  well  to  have  the  patient  rest  a  while  before  going 
home,  and  neglect  of  this  precaution  may  cause  serious  con- 
gestion. The  electricity  should  not  be  used  during  acute 
inflammation  of  the  uterus  or  adnexa. 

Infantile  Uterus. — Non-development  of  the  uterus  is 
frequently  the  result  of  overwork,  either  mental  or  physical, 
at  the  time  of  puberty,  leaving  but  little  of  the  vital  principle 
for  such  organs  as  those  of  reproduction.  The  painful 
results  following  are  practically  a  starvation  neurosis. 

The  faradic  or  sinusoidal  current  with  slow  interruptions, 
applied  by  means  of  the  dipolar  intrauterine  electrode, 
16 


PRACTICAL    ELECTRO-THERAPEUTICS. 

should  be  employed,  the  whole  influence  of  the  current  being 
concentrated  in  the  uterus.  The  frequency  of  application 
varies  from  every  day  to  once  a  week.  To  establish  a  cure 
it  should  be  employed  until  the  uterus  develops  to  a  normal 
size  and  condition. 

Scanty  and  irregular  menstruation  will  usually  respond  to 
stimulating  local  applications  to  the  cavity  of  the  uterus, 
if  made  for  a  few  days  during  the  week  immediately  preced- 
ing the  expected  period. 

During  the  intervals  local  applications  are  not  necessary. 
If  this  condition  is  the  result  or  is  associated  with  uter- 
ine atrophy,  whatever  its  cause,  results  are  as  a  rule  prompt 
when  stimulating  treatment  is  continued  twice  weekly  during 
the  intervals  between  the  menstrual  periods. 

Dysmcnorrhea. — Painful  menstruation,  when  due  to 
anemia,  seldom  requires  local  treatment.  A  tonic  course  of 
electricity  by  static  insulation,  short  sparks  or  spray  to 


Cai'bon  Ball  Klectrodes. 

the  spine,  lumbar  region  and  sacrum,  is  often  a  very 
efficient  remedy  in  these  cases. 

If  the  dysmenorrhea  is  caused  by  an  obstruction  of  the 
cervical  canal,  negative  electrolysis  applied  by  means 
of  a  .dilating  electrode  may  be  employed.  The  small- 
est sized  electrode  should  be  used  'in  the  beginning  and 
increased  in  size  at  successive  treatments,  which  may  take 
place  every  three  to  five  days.  A  current  of  ten  milliamperes 
may  be  used  for  about  five  minutes.  Sufficient  dilation  to 
overcome  the  obstructions  and  promote  free  drainage  is 
required. 

The  most  important  use  of  the  galvanic  current  in  gyne- 
cology  is  to  produce  dilatation  or  a  patulous  condition  of  the 
canal  of  the  cervix  and  secure  drainage  from  the  uterine 
cavity.  An  equally  important  effect,  that  is  obtained  at  the 
same  time,  is  a  freeing  or  expansion  of  the  orifices  and 
ducts  of  the  submucous  glands  and  a  thinning  of  their  secre- 
tions, which  permits  them  to  empty  more  freely.  It  is  a 
much  more  rational  treatment  than  the  older  method  of 


PRACTICAL    ELECTRO-THERAPEUTICS. 


2G9 


cauterization  and  astringents,  the  results  being  prompt  and 
gratifying.  The  strength  of  the  current  should  never  be 
more  than  ten  to  fifteen  milliamperes,  used  for  from  three  to 
five  minutes,  not  oftener  than  every  second  day,  better  still, 
every  third  or  fourth  day.  Drainage  from  the  tubes 
is  promoted  when  the  obstruction  is  due  to  infiltration  of 
the  endometrium  at  the  mouth  of  the  tube  and  of  the  mucous 
membrane  and  muscular  wall  at  its  uterine  end.  The  point 
of  electrode  is  directed  against  the  opening  of  the  tube  into 
the  cornu  of  the  side  affected,  or  both  sides  if  involved,  but 
no  effort  is  made  to  introduce  it  into  the  tube.  These  manip- 
ulations must  be  conducted  under  the  strictest  asepsis. 


Vaginal  Bipolar  Faradic  Application. 

An  inhibition  of  the  excretions  when  due  to  muscular 
spasm  is  almost  invariably  due  to  a  vaso-motor  disturbance, 
consequent  to  abdominal  torpidity  and  habitual  constipation. 
Positive  intrauterine  applications  may  be  necessary.  Ten 
to  twenty-five  milliamperes  are,  as  a  rule,  sufficient  to  bring 
about  results. 

Ovarian  Congestion. — Abdominal  dorsal  applications  of 
both  currents  with  general  galvanic  stimulation  and  massage 
usually  relieve  this  trouble. 

Relaxed  abdominal  walls  may  be  frequently  corrected  by 
means  of  the  faradic  as  well  as  galvanic  currents,  one  pad 
being  applied  on  the  abdomen  and  another  on  the  back.  The 
pad  on  the  abdomen  should  follow  the  direction  of  the  colon 
and  pass  down  the  flanks  on  each  side..  The  current  con- 


270 


PRACTICAL    ELECTRO-THERAPEUTICS. 


tracts  the  dilated  intestines  gradually,  adding  tone  to  the 
muscular  walls. 

Electricity  at  the  bedside  not  only  frequently  replaces 
opium  and  other  sedatives,  but  materially  reduces  the  extent 
and  duration  of  the  inflammation.  The  electrode  should 
always  be  warmed  before  insertion.  The  current  from  the 
long,  fine  secondary  wire  is  used  for  fifteen  to  twenty  min- 
utes, and  if  great  relief  is  experienced  it  may  be  repeated 
twice  daily  if  necessary.  Its  use  is  not  only  followed  by 
lessened  pain,  but  by  relieving  the  hypertrophied  condition. 

Drainage  of  the  uterus  by  means  of  the  negative  galvanic 
pole  may  cure  a  considerable  proportion  of  all  cases,  but  ii 
the  progress  is  not  as  rapid  as  desirable  intrauterine  appli- 
cations may  be  made.  Twenty  milliamperes  will  be  ample 
during  the  beginning  of  the  treatment,  and  applications  may 


Ovarian  Electrode. 

be  made  every  four  or  five  days.  The  vagino-abdominal 
treatment  may,  however,  be  continued  as  usual.  Care  must 
be  taken  not  to  aggravate  the  trouble,  which  would  certainly 
occur  in  the  presence  of  purulent  inflammation. 

Chronic  Ovaritis. — The  normal  function  of  the  ovaries 
when  inflamed  may  frequently  be  restored  and  adhesions 
loosened  by  the  absorption  of  the  bands  of  exudates  by 
means  of  the  bipolar  fine  wire  faradic  applications  for  five 
minutes  daily,  or  by  the  galvanic  current  applied  by  means 
of  zinc  or  carbon  covered  electrodes  with  a  current  of  thirty 
to  sixty  milliamperes. 

Ovarian  Neuralgia. — Marked  relief  is  usually  brought 
about  by  the  rubefacient  effect  produced  by  static  spray  or 
by  means  of  the  glass  electrode  of  high  frequency  applied 
over  the  clothing  about  the  lower  abdominal  and  sacral 


PRACTICAL    ELECTRO-THERAPEUTICS.  271 

regions.  The  static  wave  current  with  large  spark-gap  may 
also  be  applied  over  the  painful  area. 

Amenorrhca,  when  the  result  of  a  chronic  metritis,  requires 
energetic  treatment.  Strong  currents  must  be  used  to 
stimulate  the  impaired  muscular  structure  of  the  uterus. 
When  a  metal  electrode  is  introduced  into  the  uterus  and  a 
strong  current  used  the  metal  part  of  the  electrode  must  not 
come  in  contact  with  the  cervical  canal,  as  the  resultant 
cauterization  is  likely  to  result  in  a  stenosis. 

The  bipolar  faradic  electrode  must  also  pass  wholly  into 
the  uterus,  as  the  external  os  is  extremely  sensitive.  The 
stimulation  should  be  made  as  strong  as  can  be  comfortably 
borne.  Some  can  bear  only  the  fine  wire  coil,  while  others 
bear  the  coarse  wire  coil  without  apparent  discomfort. 
Continue  treatment  four  to  five  minutes  twice  a  week  or 
more. 


Bipolar  Uterine  Electrodes. 

Metrorrhagia. — Endometrial  hemorrhage  is,  as  a  rule,  due 
to  a  diseased  condition  of  the  endometrium.  When  not  con- 
traindicated  by  accumulation  of  pus  or  septic  exudates  in 
the  pelvis,  tubes  or  ovaries,  electricity  may  be  used  to 
combat  this  trouble,  though  it  must  by  no  means  constitute 
the  only  remedy.  It  should  usually  be  preceded  by  curettage. 
When  the  canal  is  not  patulous  it  should  be  first  dilated 
either  by  a  steel  dilator  or  by  means  of  negative  electrolysis 
to  permit  free  drainage.  The  uterine  canal  must  be  thor- 
oughly irrigated  to  remove  shreds  of  blood  before  each  treat- 
ment, to  permit  the  electrode  to  come  in  contact  with  the 
parts. 

When  positive  electrolysis  is  used  to  control  uterine 
hemorrhage,  fifty  to  one  hundred  milliamperes  will  be 
required  and  must  be  continued  for  some  time. 

Metallic  electrolysis  is  very  energetic  and  penetrates  to  a 
greater  depth,  which  is  a  decided  advantage  over  dry  cauter- 
ization by  means  of  positive  electrolysis.  Copper  or  zinc 


272  PRACTICAL    ELECTRO-THERAPEUTICS. 

electrodes  may  be  used,  copper  being  the  most  astringent  as 
well  as  the  most  irritating.  Zinc  is  followed  by  little  irrita- 
tion, but  not  by  a  profuse  discharge,  as  is  copper  electrolysis. 
The  cervical  canal  must  be  excluded  from  its  action. 

The  electrode  should  fill  the  cavity  as  completely  as 
possible,  but  if  the  cavity  is  longer  than  normal  it  will  be 
necessary  to  act  on  each  section  separately.  A  current 
of  fifteen  to  thirty  milliamperes  may  be  used  for  five  to  ten 
minutes,  and  if  the  electrode  sticks  the  current  should  be 
reversed. 

Irrigate  the  canal  at  least  every  twenty-four  hours  until 
application  is  repeated,  which  may  be  on  third  or  fourth  day, 
especially  if  bleeding  is  active  and  interferes  with  effective 
cauterization. 

If  the  hemorrhage  is  due  to  hyperemia  of  the  endometrium, 
caused  by  engorgement  of  uterine  vessels  from  pressure  of 
tumor,  etc.,  a  vagino-lumbar  or  vagino-abdominal  applica- 
tion will  often  prove  effective  in  controlling  bleeding. 

Subinvolntion  may  be  more  successfully  and  quickly 
treated  by  means  of -electricity  than  by  any  other  means  at 
our  disposal.  Flagging  muscular  tissue  rapidly  shrinks 
after  a  few  stimulating  applications  from  a  primary  or 
secondary  coarse  wire  coil.  Discharges  continuing  after 
the  normal  period  following  parturition  may  frequently  be 
controlled  by  one  or  two  applications.  If  there  is  a  morbid 
condition  of  the  endometrium  present  the  positive  covered 
elastic  uterine  electrode  is  best  suited,  as  its  introduction 
causes  least  pain. 

If  a  septic  condition  is  present  the  positive  mercuric  pole 
may  be  used,  on  account  of  its  bactericidal  power. 

The  bipolar  vaginal  method  is  first  used,  because  its 
action  is  more  diffuse  than  when  applied  to  the  interior  of 
the  uterus.  Application  is  of  short  duration  to  avoid  tiring 
the  muscles,  and  interruption  should  be  sufficiently  slow  to 
permit  physiological  contractions  and  relaxations.  This 
is  borne  without  discomfort  if  the  nervous  apprehension  lias 
been  previously  overcome.  Treatment  should  be  every  day 
in  the  beginning,  and  after  two  weeks  every  third  or  fourth 
day.  If  the  impaired  muscle  structure  responds  poorly  to 
the  faradic  current,  an  interrupted  galvanic  current  should 
be  used,  as  its  amperage  or  volume  can  be  increased  until 
response  is  elicited. 


PRACTICAL    ELECTRO-THERAPEUTICS. 


273 


The  bipolar  vaginal  electrode  is  also  used  to  remove  the 
obstruction  in  the  tube  and  to  stimulate  the  absorption  of 
the  infiltration  of  its  walls  and  lining  membrane.  Great 
care  must  be  exercised  in  acute  cases.  Being  a  stimulant, 
it  may  provoke  undesirable  and  even  harmful  irritation  by 
improper  administration. 

Uterine  Displacement. — The  treatment  must  be  directed 
against  the  conditions  operating  to  produce  it,  subinvolution, 
endometritis,  metritis,  etc.  The  possibility  of  a  cure  with- 
out an  operation  will  depend  upon  whether  the  tonicity  of 
the  sustaining  ligaments  can  be  restored  and  whether  the 
uterus  is  movable  or  not. 

Where  the  uterus  is  movable,  but  is  restrained   by   the 


Applying  Negative  Electrolysis  to  Female  Urethra. 

thickened  utero-sacral  ligaments,  the  treatment  is  directed 
towards  the  absorption  of  the  inflammatory  deposits  in  the 
surrounding  cellular  tissue.  The  negative  electrode,  with 
a  current  of  from  twenty-five  to  forty  milliamperes,  will 
have  the  effect  of  softening  the  parts,  after  which  the 
bipolar  faradic  electrode  applied  for  about  ten  minutes  will 
by  its  stimulating  properties  cause  rapid  absorption. 

Erosions  of  the  Os. — Removal  of  the  exciting  cause  is 
always  necessary  for  a  permanent  cure.  Local  applications 
to  the  excoriated  surfaces,  of  a  normal  salt  solution,  ap- 
plied by  means  of  wet  cotton  attached  to  the  positive  pole 
with  a  current  flow  of  about  twenty  milliamperes  will  greatly 
aid  in  promoting  the  healing  process.  Treatments  may  be 
repeated  every  two  to  three  days. 

18 


274  PRACTICAL    ELECTRO-THERAPEUTICS. 

Cervical  Endometritis. — This  disease  is  almost  invariably 
an  obstinate  affection  and  of  a  penetrating  microbic  origin, 
and  being  almost  always  associated  with  corporeal  endome- 
tritis.  This  being  the  case,  zinc,  mercuric  cataphoresis  or 
mercury  on  copper  or  silver  is  usually  very  effective  if 
applied  through  the  cervical  canal  with  thirty  to  fifty 
milliamperes  for  a  period  of  five  minutes.  On  removal,  the 
positive  electrode  will  be  found  to  have  adhering  to  it  a 
mass  of  albuminous  material,  coagulated  by  the  acid  action 
of  the  positive  pole.  Examination  of  the  cervical  canal  will 
show  it  to  be  denuded  of  mucus  clear  down  to  the  nebothian 
glands.  A  number  of  applications  of  this  kind  are  as  a  rule 
necessary,  though  the  secretions  have  a  tendency  to  become 


Electrodes  in  Position  for  Vagino-Lumbar  Application. 

less  at  each  seance.     The  plain,  positive    current    with    a 
platinum  electrode  is  frequently  effective. 

Endometritis. — The  simple  catarrhal  condition  is  usually 
due  to  a  hyperemic  condition  of  the  uterus  consequent  to 
constipation,  torpid  liver,  exposure  to  cold,  etc.  Removal  - 
of  the  cause  is  the  first  indication.  Applications  of  the  static 
spray  or  spark  or  high  frequency  current  by  means  of  glass 
electrodes  over  the  sacral  and  lumbar  regions  as  a  rule  make 
local  applications  unnecessary.  When  local  measures  are 
indicated  the  faradic  bipolar  applications  are  -as  a  rule 
sufficient  and  produce  effects  not  otherwise  obtainable. 

In  chronic  endometritis  the  secreting  cavity  of  the  uterus 
which  is  normally  open  becomes  closed  and  normal  secretions 


PRACTICAL   ELECTRO-THERAPEUTICS.  275 

confined  become  a  source  of  irritation.  Negative  electrol- 
ysis may  here  become  necessary.  Applications  by  means  of 
a  uterine  electrode  with  a  current  of  about  ten  milliamperes, 
continuing  for  five  minutes,  may  be  repeated  every  two  to 
five  days.  Bipolar  stimulation  may  also  be  used  two  to  three 
times  a  week,  as  the  case  may  demand,  until  free  drainage 
has  been  fully  established. 

Septic  Endometritis. — Cupric  cataphoresis  on  account  of 
its  germicidal  action  is  very  efficient  in  this  class  of  cases, 
and  causes  the  patient  less  pain  and  inconvenience  than  a 
curettemenf,  which  of  necessity  must  always  be  done  under 
an  anesthetic  with  the  accompanying  risk.  The  application 
should  be  made  by  means  of  an  intrauterine  electrode, 
selected  to  well  fill  the  uterine  cavity.  Attached  to  the 
positive  pole  a  current  of  thirty  to  fifty  milliamperes  is 
gradually  turned  on  and  allowed  to  flow  for  ten  minutes. 
Treatments  may  be  repeated  every  other  day.  Gently  rotate 
the  electrode  during  treatment  to  prevent  it  from  sticking. 

Metritis. — This  condition  may  persist  after  the  inflamma- 
tory condition  of  the  endometrium  has  disappeared  and  is 
sometimes  most  intractable. 

Irrigation  with  a  negative  galvanic  pole  and  a  current  of 
forty  to  fifty  milliamperes  sometimes  gives  great  relief, 
if  applied  thrice  weekly.  In  applying  cauterization  to  the 
uterus  it  must  be  done  in  such  a  way  as  not  to  cauterize  the 
uterine  canal,  which  would  defeat  the  purpose  by  subsequent 
cicatricial  contractions. 

If  we  desire  to  avoid  deep  cauterization  it  is  absolutely 
necessary  to  keep  the  electrode  in  motion  over  the  surface.  If 
bleeding  should  supervene,  the  treatment  must  be  suspended 
until  it  ceases.  Never  turn  on  more  current  than  an  inflamed 
organ  can  bear.  The  first  treatments  should  continue  for 
only  five  minutes. 

Senile  Endometritis. — This  condition  of  atrophic  degenera- 
tion is  coincident  with  the  menopause.  The  uterine  cavity 
is  filled  with  irritating,  excoriating  secretions.  The  absorp- 
tion of  this  material  provokes  general  sepsis,  owing  to  the 
constriction  of  the  canal  by  bands  of  cicatricial  tissue. 
As  this  cicatricial  tissue  will  not  stretch  without  tearing, 
negative  galvanism  with  its  dilating  effect  is  the  only  proper 
remedy  to  employ.  As  the  condition  is  a  progressive  one, 
it  can  not  be  cured  in  a  short  time,  though  marked  improve- 
ment often  occurs. 


276  PRACTICAL    ELECTRO-THERAPEUTICS. 

The  irrigator  may  be  used  as  an  electrode  when  the  canal 
is  sufficiently  dilated  to  admit  it.  Application  may  be 
made  every  second  day  for  three  to  four  weeks,  and  once  a 
week  for  the  succeeding  weeks. 

Catarrhal  Salpingitis. — In  acute  cases  of  catarrhal  sal- 
pingitis  bipolar  faradization  carefully  applied  will  relieve  pain, 
lessen  congestion  and  remove  the  tumefaction  by  stimulating 
the  absorption  of  infiltration.  This  will  promote  drainage  of 
the  retained  tubal  secretions  into  the  uterus,  both  by  lessen- 
ing pelvic  hyperemia  upon  which  it  depends  and  by  removing 
the  obstruction  in  the  tubes.  Care  must  be  exercised  in 
acute  stages,  for  we  are  dealing  with  a  stimulant  and  even 
harmful  results  may  follow  its  improper  administration. 

The  current  from  the  fine  wire  coil  should  be  employed 
first.  The  application  must  always  be  grateful  to  the  patient, 
never  uncomfortable.  Each  application  must  continue 
until  relief  is  experienced  and  sedation  is  produced.  The 


=€*• 


Intrauterine  Electrodes. 

application  must  be  repeated  sufficiently  often  to  maintain 
quiescence,  which  may  mean  several  times  a  day.  Employed 
in  this  manner  electricity  may  be  made  to  take  the  place  of 
opium.  The  patient  must,  of  course,  be  confined  to  bed,  in 
the  recumbent  posture,  until  the  acute  symptom  subsides. 

When  the  acute  sensitiveness  has  subsided  recovery  will 
be  hastened  by  means  of  the  cotton-covered  carbon  ball  elec- 
trode in  the  vagina,  the  indifferent  electrode  being  over  the 
lumbar  region.  The  galvanic  current  may  be  used  for  five 
minutes  before  using  the  faradic  stimulation.  If  the  infil- 
tration is  soft,  make  the  vaginal  electrode  positive;  if  hard, 
make  it  negative;  but,  as  a  rule,  the  negative  is  more  appro- 
priate. Twenty  to  fifty  milliamperes  may  be  used,  accord- 
ing to  the  susceptibility  of  the  patient. 

If  the  current  produces  an  aching  sensation  the  current 
strength  must  be  reduced  at  once.  Electricity  is  especially 
serviceable  when  the  case,  is  one  of  long  standing.  Daily 
applications  should  be  made  during  the  first  week,  and  later 
every  second. 


PRACTICAL   ELECTRO-THERAPEUTICS.  277 

Pyosalpinx. — In  purulent  infiltration  of  the  ovaries  and 
tubes,  electricity  is  of  no  avail  except  possibly  as  it  may 
promote  drainage.  It  is  usually  contraindicated,  as  the 
positive  pole  may  cause  absorption  of  pus.  Cure  by  elec- 
tricity seems  to  be  out  of  the  question. 

Hematosalpinx. — Absorption  may  be  promoted  by  means 
of  the  negative  galvanic  current,  thirty  to  fifty  milliamperes. 

Hydrosalpinx. — Following  aspiration,  application  of  the 
positive  electrode  through  the  cavity  will  prevent  the  recur- 
rence of  the  trouble. 

Pelvic  peritonitis. — The  bipolar  fine  wire  faradic  current 
occasionally  gives  good  results. 

Vomiting  of  pregnancy. — The  sedative  action  of  the  posi- 
tive pole  of  the  galvanic  current,  when  applied  to  the  pneu- 
mogastric  nerve,  frequently  is  followed  by  marked  relief.  A 
current  strength  of  ten  to  fifteen  milliamperes  maintained  for 
ten  minutes  is  usually  sufficient  to  bring  about  the  desired 
result. 

The  high  frequency  and  faradic  currents  applied  to  the 
epigastrium  are  also  highly  spoken  of  by  various  operators. 

Postpartnm  hemorrhage  is  treated  by  placing  one  electrode 
on  the  abdomen  and  the  other  on  the  back,  using  the  faradic 
current. 

After-pains. — The  secondary  faradic  current  from  the  fine 
wire  coil,  applied  for  about  five  minutes  by  means  of  sponge 
electrodes  to  lumbar  spine  and  abdomen,  is  usually  very  effi- 
cient. 

In  ectopic  gestation  the  interrupted  galvanic  or  faradic 
current  will  destroy  the  life  of  the  fetus,  thus  arresting  the 
development  of  gestation  and  promoting  the  ultimate  disap- 
pearance of  the  product  by  absorption.  It  is  justifiable  and 
feasible.  After  a  rupture  nothing  is  gained  except  by  an 
operation.  Electricity  can  be  employed  with  safety  while 
in  doubt,  waiting  to  establish  a  positive  diagnosis,  and  if 
complete  absorption  fail  it  can  be  removed  with  safety  later 
on. 

It  is  best  to  insert  one  electrode  in  the  vagina  and  the  other 
in  the  rectum  beyond  the  tumor  mass.  The  electrodes  should 
be  covered.  The  treatment  may  continue  five  minutes  with 
a  current  strength  according  to  the  susceptibility  of  the 
patient. 

Sterility  is  frequently  due  to  an  inflammation  of  the  cervix 


278  PRACTICAL    ELECTROTHERAPEUTICS. 

and  endometrium.  An  actual  cure  of  these  conditions  would 
undoubtedly  cure  many  cases. 

In  the  treatment  of  sterility  it  is  necessary  to  correct  the 
conditions  of  chlorosis  and  anemia.  The  uterus  and  ovaries 
should  be  stimulated  by  means  of  galvanism  and  faradism 
in  order  to  hasten  development.  The  negative  galvanic 
application  to  canal  of  the  cervix  twice  a  week  for  several 
months  will  alter  the  diseased  secretions  which  frequently 
interfere  with  conception.  If  the  secretions  are  acid  these 
applications  to  uterus  will  correct  this  condition.  After 
three  months'  treatment  suspend  treatment  and  \vatch  for 
results.  If  the  secretions  are  alkaline,  use  the  positive  pole, 
with  platinum  or  carbon  electrode  in  the  vagina,  with  twenty 
to  thirty  milliamperes  for  about  five  minutes  every  two  or 
four  days. 

Menopause. — Galvanic  and  faradic  currents  have  both 
proven  successful.  The  faradic  is  most  used,  the  current 
being  as  strong  as  the  patient  can  bear  it.  Use  on  alter- 


Block  Tin  Intrauterine  Electrode. 

nate  days.  The  negative  galvanic  current  may  be  used  to 
promote  absorption.  The  positive  electrode  when  used  should 
be  made  of  either  platinum  or  carbon. 

The  hot  flashes,  headaches  and  other  nervous  disturbances, 
are  best  treated  by  means  of  static  electricity.     Small  spark 
applied  all  over  the  body,  as  well  as  static  insulation,  acts  as 
a  sedative  to  the  nerves. 

Fibroids. — The  actual  disappearance  of  a  fibroid  tumor 
seldom  occurs  under  the  use  of  electricity,  though  frequently 
a  considerable  reduction  in  the  size  of  the  growth  may  be 
caused,  as  well  as  a  cessation  of  the  symptoms.  Operations, 
being  comparatively  safe,  should  always  be  resorted  to,  unless 
contraindications  exist.  Electricity  may  often  be  employed 
to  advantage  preparatory  to  operative  procedure  to  clear  up 
exudates.  Absorption  of  serous  infiltration,  fibrinous  exu- 
dations, blood  extravasations  of  pelvis,  are  promoted  by  the 
positive  pole  of  the  constant  current,  and  if  carried  far 
enough  has  a  marked  effect  upon  the  nutrition,  in  conse- 
quence of  which  a  retrograde  action  must  ensue.  The  posi- 


PRACTICAL    ELECTRO-THERAPEUTICS.  279 

tive  pole  is  used  by  means  of  the  cotton-covered  carbon  elec- 
trode, well  moistened  or  soaked  in  glycerine. 

Intrauterine  applications  cut  off  the  nourishment  from  the 
parts  much  more  rapidly  than  the  vaginal  applications. 

Applications  of  solutions  of  supra-renal  capsule  may  be 
made  by  using  a  hard  rubber  electrode,  hollowed  throughout 
and  having  small  holes  at  the  lower  end  through  which  the 
fluid  flows  and  thus  permits  electrical  connection  between 
the  tissues  and  the  twisted  wire  applicator  around  which  is 
placed  a  loose  winding  of  gauze  saturated  with  the  medica- 
ment. 

The  excessive  hemorrhages  that  frequently  accompany 
growths  of  the  fibroma  of  the  uterus  are  usually  due  to  a 
fungoid  change  in  the  endometrium,  that  becomes  very 
vascular,  owing  to  the  obstruction.  This  condition  can 
generally  be  relieved  by  application  of  the  positive  electrode 
in  the  uterus.  After  treatment  the  uterus  may  be  con- 
siderably reduced  in  weight. 

Galvanism  has  no  beneficial  effects  on  fibroids  that  have 
undergone  cystic  degeneration,  but,  on  the  contrary,  may  do 
harm.  Myomata  and  interstitial  growths  seem  to  be  more 
amenable  to  treatment  than  fibroma. 

In  treating  a  fibroid  growth  the  electrodes  must  be  so 
placed  as  to  include  the  mass  between  them,  the  negative  or 
positive  pole  being  selected  as  the  active  electrode,  accord- 
ing to  the  effects  desired.  The  negative  electrode  is  used  in 
the  tumor  when  hard  and  no  hemorrhage  is  present,  and  a 
current  strength  of  from  twenty-five  to  one  hundred  and 
fifty  milliamperes  may  be  used.  A  large  pole  should  be  used 
on  the  abdomen,  or  it  will  be  painful.  A  wet  towel  is  a 
good  electrode,  but  should  be  so  placed  as  not  to  touch  the 
thighs  or  pubes,  and  any  wound  should  be  covered  with  col- 
lodion to  prevent  an  eschar. 

For  pain  the  fine  wire  faradic  current  may  be  used.  The 
positive  pole,  with  the  constant  current  and  a  current 
strength  of  from  twenty-five  to  fifty  milliamperes  for  two 
minutes,  may  also  relieve  the  pain. 

Galvano-puncture  involves  the  risks  of  injuring  the  uterus 
and  blood-vessels,  and  experience  shows  that  growths  are 
rarely  situated  conveniently  for  puncture  through  the  vagina. 
Galvano-puncture  is  followed  by  more  rapid  symptom  ame- 
lioration and  may  be  absolutely  indicated  in  some  cases. 


,280  PRACTICAL    ELECTRO-THERAPEUTICS. 

Electrolytic  destruction  is  not  wanted,  but  rather  a  regres- 
sive metamorphosis  of  the  growth. 

Strictest  asepsis  is  necessary  to  prevent  infection,  which, 
in  spite  of  all  care  is  frequently  followed  by  peritonitis.  In 
treatment  of  exudates  into  the  broad  ligament,  the  puncture 
must  be  made  near  the  uterine  wall,  and  should  not  penetrate 
more  than  one  fourth  of  an  inch.  Treatment  should  be  given 
once  a  week,  and  not  repeated  if  no  impression  is  made. 


GENITOURINARY  TRACT. 

STRICTURES. 

Clinical  experience  has  demonstrated  that  after  a  few 
minutes'  application  of  the  cathode  or  negative  pole  to  a 
stricture  the  resisting  bands  become  less  dense  and  less 
obstruction  is  offered  to  the  dilating  instrument.  After  a 
succession  of  such  applications  the  bands  are  softened  and 
rendered  more  yielding,  and  are  absorbed,  in  part  at  least. 
Notwithstanding  the  time  required,  it  is  less  dangerous  than 
forcible  urethrotomy  and  equally  satisfactory  in  results. 

Cathodal  electrolysis  meets  the  conditions  necessary  for 
relief,  and  has  been  practiced  upon  urethral  stricture  more 
than  on  any  other  on  account  of  its  predominance  in  number 
of  cases.  In  urethral  strictures  rapid  cathodal  electrolysis 
with  a  strong  current  (twenty  to  thirty  milliamperes)  has 
been  abandoned,  and  the  slow  method  of  five  milliamperes  or 
less  for  a  period  of  five  minutes  is  now  employed.  This  method 
has  been  much  criticised  and  failures  have  almost  always  re- 
sulted where  a  stronger  current  was  used. 

In  cathodal  electrolysis  we  use  only  mild  currents  with 
batteries  from  small  cells  containing  weak  fluids.  A  bat- 
tery presenting  a  large  surface  and  big  cells  is  unsuitable,  as 
it  will  cauterize  more  rapidly  and  more  intensely  than  a  caus- 
tic, and  by  the  destruction  of  tissue  and  consequent  suppu- 
ration aggravate  the  trouble. 

Before  using  a  sound  or  electrode  it  is  well  to  inject  an 
antiseptic  solution  into  the  canal.  The  electrode  must  be 
insulated  except  at  the  point  where  action  is  desired,  and  it 
should  be  coated  with  a  lubricant  which  offers  little  resistance 
to  the  current.  Vaseline  is  dangerous  as  a  lubricant,  as  it 
may  enter  the  bladder,  cake  and  become  the  nucleus  for  a 
vesical  calculus.  The  olive-tipped  electrode  for  treating 
stricture  should  be  made  of  one  piece,  as  the  screw  thread 
frequently  wears  out  and  tlie  tip  can  not  be  firmly  attached. 

,  281 


282 


PRACTICAL    ELECTRO-THERAPEUTICS. 


If  the  canal  is  very  irritable  inject  a  two  to  four  per  cent. 
solution  of  cocaine  or  introduce  a  suppository   containing  — 


Extract  Belladonna:  .  .  .  .  gr.  /4 

Aquae  Ext.  Opii  .......  gr.  1. 

Cocoa  Butter  ..........  O.  S. 


to 


Anesthetics  are  not  used.  Don't  operate  during  the  acute 
or  subacute  inflammatory  condition.  Only  one  instrument 
should  be  introduced  into  the  urethra  at  each  operation. 
For  an  ordinary  stricture  use  an  electrode  three  sizes  larger 
than  the  stricture. 

The  olive-tipped  electrode  is  passed  into  the  canal  until  it 
becomes  partially  engaged  in  the  strictured  area.  The  posi- 
tive pole  of  large  surface  is  well  moistened  and  kept  well  in 


Urethral  Electrodes. 

place  on  the  breast,  back  or  hand,  and  the  current  of  from 
three  to  five  milliamperes  is  gradually  let  into  the  circuit. 
The  tip  is  kept  gently  in  cqntact  with  the  stricture  until  the 
tip  of  the  instrument  slowly  moves  onward  past  the  point  of 
obstruction.  This  may  require  from  two  to  twenty  minutes, 
but  a  longer  treatment  is  not  advisable.  If  the  electrode 
passes  through  the  stricture  in  a  few  seconds  bring  it  back 
and  hold  it  in  place  for  a  few  minutes  to  prolong  the  effect 
of  electrolysis  at  one  sitting.  It  is  sometimes  necessary  to 
use  the  same  electrode  for  several  successive  treatments,  as 
determined  by  the  nature  of  the  stricture.  Too  much  should 
not  be  attempted  at  one  sitting. 

Its  action  is  slow,  gradual,  dissolving  or  disintegrating, 
and  should  be  repeated  at  intervals  of  five  days  to  two  or 
three  weeks  until  the  size  of  the  normal  urethra  is  reached. 


PRACTICAL    ELECTRO-THERAPEUTICS.  283 

Gleet. — The  faradic  current  may  be  used,  with  a  preference 
for  the  positive  pole  in  the  urethra,  the  negative  pole  being 
placed  over  the  lumbar  plexus.  The  benefit  arises  from  a 
stimulation  of  the  mucous  membrane  and  the  glands.  A 
sound  may  be  used,  but  an  electrode  with  two  to  three  inches 
free  and  uninsulated  will  answer  the  purpose  better. 

The  galvanic  current  may  also  be  used;  the  pole  must  be 
selected  according  to  the  effect  desired.  A  current  stronger 
than  five  milliamperes  is  apt  to  overstimulate  and  even 
cause  inflammation  and  bring  on  a  consequent  discharge. 
Hydro-galvanism  is  useful  when  the  parts  are  painful,  but 
do  not  displace  the  solid  metal  electrode. 

Chancroids. — Saturate  the  parts  thoroughly  with  oxychlo- 
ride  of  copper.  After  moistening  the  parts  with  a  normal 


Urethral  Electrodes. 

salt  solution,  apply  the  copper  electrode  attached  to  the 
positive  pole  until  the  parts  have  a  deep  green  stain. 

Vesical  spasm  is  usually  a  symptom  of  some  other  dis- 
order. Both  galvanic  and  faradic  currents  have  been  suc- 
cessfully used,  and  either  is  beneficial.  The  positive  pole  is 
used  in  the  urethra  and  the  negative  pole  over  lumbar  spine. 
The  current  is  slowly  increased  until  the  sound  or  electrode 
passes  into  the  bladder.  The  induced  current  from  a  long 
coil  of  fine  wire  is  preferable  in  the  beginning. 

If  the  cause  of  spasm  is  general  or  central  paralysis,  use 
the  galvanic  current  with  two  pad  electrodes  over  the  spine, 
or  the  anode  (positive  pole)  over  the  lumbar  region  and  the 
cathode  (negative  pole)  over  the  bladder.  Eight  to  twelve 
milliamperes  may  be  used  for  ten  minutes. 

If  the  muscle  of  the  bladder  has  lost  its  contractile  power 
hydro-galvanism  is  indicated. 


28-i  PRACTICAL    ELECTRO-THERAPEUTICS. 

Local  use  of  the  faradic  current  to  the  spine  is  contra- 
indicated  in  nervous  patients. 

Cystitis  with  painful  tenesmus. 

For  this  disease  use  a  flat  electrode  tinder  the  sacrum  and 
a  carbon  electrode  and  pad  to  the  perineum.  Through  the 
tissues  pass  a  circuit  of  twenty  low  tension  cells  for  ten 
minutes.  It  is  frequently  surprising  how  quickly  the  pain 
vanishes  and  tenesmus  is  lessened. 

Impotcncy. — Associated  with  suggestion,  static  electricity 
is  undoubtedly  more  beneficial  than  any  other  form  of  treat- 
ment. Sparks  to  the  lumbar  spine  and  perineum,  as  well  as 
the  static  wave  current  to  these  parts,  are  indicated.  Fric- 
tion sparks  and  Leyden  jar  currents  may  also  be  used  locally 
on  the  penis  with  effect. 

All  electrical  modalities  have  been  tried,  with  success  in 
sonie  cases  and  failures  in  others.  The  positive  electrode 
may  be  placed  on  lumbar  cord,  the  negative  along  the  seminal 


Tunneled  Electrode. 

canal  from  the  lingual  ring  downward.  The  current  should 
produce  a  distinct  burning  sensation.  Then  one  minute 
labile  application  along  the  upper  and  lower  surface  of  the 
penis  as  far  as  the  glands.  Finally  the  cathode  (negative 
pole)  may  be  applied  to  the  perineum  for  two  minutes.  If 
the  testicles  are  atrophic,  pass  the  current  directly  through 
them. 

Enurcsis. — The  treatment  of  enuresis  consists  largely  in 
building  up  the  body  generally  and  locally  and  in  removing 
the  irritating  cause.  Stretching  the  rectal  sphincter  is  fre- 
quently followed  by  marked  relief.  The  nerves  of  the  de- 
truso  urinse  muscle  and  the  sphincter  ani  have  a  common 
source;  this  being  the  case,  we  are  justified  in  assuming 
that  what  will  cause  a  spastic  contraction  in  the  one  will 
do  so  reflexly  in  the  other.  Local  treatment  should  consist 
largely  in  strengthening  the  sphincter  muscle  at  the  neck 
of  the  bladder  by  causing  an  increase  in  muscular  cell 
growth.  This  is  best  accomplished  by  means  of  an  inter- 


PRACTICAL    ELECTRO-THERAPEUTICS.  285 

rupted  induced  current  causing  the  muscle  to  contract  and 
relax,  exercising  every  part  of  the  tissue  and  brings  about 
better  nourishment  in  the  parts. 

Direct  stimulation  of  the  vesical  sphincter  may  be  used  in 
females,  where  the  canal  is  short  and  the  parts  can  be  ren- 
dered thoroughly  aseptic.  The  other  pole  should  be  placed 
over  the  lumbar  spine.  In  boys  one  pole  may  be  placed 
over  the  perineum  or  up  against  the  prostatic  urethra,  using 
a  short  rectal  electrode  for  this  purpose.  Many  brilliant 
results  have  followed  this  treatment  where  medication  lias 
failed.  Care  must  be  taken  not  to  give  too  long  treatments, 
as  the  muscles  would  be  worn  out  and  great  harm  result. 
Begin  treatments  with  one  or  two  minute  seances,  gradually 
increasing. 

Regulate  the  interruption  of  the  battery  so  that  the  mus- 
cles may  contract  and  come  back  normally  between  each 
interruption.  Rapid  interruptions  merely  tetanize  and  tire 


Prostatic  Electrode. 

out.  It  is  best  to  use  a  rheotome  in  which  the  number  of 
interruptions  may  be  controlled. 

Where  incontinence  depends  on  the  hyperexcitability  of 
the  vesical  mucosa,  the  sedative  influence  of  galvanism 
should  be  used.  Where  the  trouble  is  due  to  weakness 
of  the  vesical  centers  in  the  spine,  galvanism  may  be 
used  to  increase  the  activity  in  this  particular  center. 

In  hydrocde  the  positive  needle  is  inserted  into  the  tumor. 
This  treatment  frequently  prevents  secretions  and  determines 
absorption. 

Varicocele. — Insert  a  silver  needle  into  the  vein  and  con- 
nect it  with  the  positive  pole  of  the  galvanic  current.  Apply 
ten  to  fifteen  milliamperes.  This  procedure  will  bring 
about  occlusion  of  the  vessel,  the  same  as  tying  it  would. 
Carried  out  with  antiseptic  precautions,  it  is  altogether  with- 
out danger. 

In  the  treatment  of  prostatiiis,  acute  or  chronic,  static  elec- 
tricity by  means  of  the  wave  current  is  frequently  verj 


28G  PRACTICAL    ELECTRO-THERAPEUTICS. 

effective.  The  rectal  electrode  should  be  about  five  inches 
in  length,  adapted  to  the  conformation  of  the  glands  and 
reaching  the  seminal  vesicles.  In  patients  not  suffering 
from  constipation  it  is  well  to  use  the  insulated  electrode, 
thereby  relieving  the  sphincter  muscle  from  a  painful  con- 
traction which  would  otherwise  be  induced.  The  base  of  the 
electrode  may  be  set  either  flat  upon  the  chair  or  elevated  at 
either  extremity,  in  order  to  bring  a  proper  pressure  or 
contact  with  the  diseased  parts.  The  spark-gap  should  be 
regulated  as  tolerance  permits  (from  six  to  twelve  inches). 
The  use  of  a  urethral  sound  of  a  large  size  may  be  conven- 
iently carried  to,  but  not  into,  the  vesical  sphincter,  where 
it  would  produce  a  disagreeable  contraction.  The  spark- 
gap  here,  as  in  the  rectum,  must  be  regulated  by  the  sensa- 
tion produced. 

Galvanic  electricity  has  been  used  for  years  by  various 
operators,  with  varying  success.  The  negative,  being  made 
the  active  electrode,  may  be  applied  either  by  rectum  or 
urethra. 

Galvano-puncture  of  the  hypertrophied  prostate  (per  rec- 
tum) by  means  of  the  negative  platinum  needle  has  also  met 
with  success  in  some  cases. 

Many  cases  will  be  more  benefited  by  the  electrode  in  this 
position  than  in  any  other. 

The  galvano-caustic  method  introduced  by  Bottini  is  per- 
formed as  follows: 

After  washing  out  the  bladder  the  posterior  urethra  is 
anesthetized  by  means  of  cocaine.  The  instrument  is  intro- 
duced with  the  electric  current  broken.  In  order  to  burn 
a  groove  the  concavity  of  the  instrument  is  turned  towards 
the  desired  spot.  The  instrument  is  slightly  withdrawn,  so 
that  its  concave  surface  will  hug  the  prostate.  The  current 
is  turned  on.  The  surgeon  waits  fifteen  seconds  for  the  blade 
to  heat  and  then  projects  the  blade  to  the  required  extent 
by  means  of  a  screw  handle.  When  a  sufficient  groove  has 
been  produced  the  cautery  is  returned  to  its  sheath.  A 
second  and  third  furrow  can  be  burned  in  this  manner. 
Bottini  burns  three  furrows,  a  moderately  deep  one 
towards  the  rectum  and  a  deep  one  into  the  lateral  lobe 
which  is  most  markedly  enlarged.  After  the  furrows  have 
been  burned  the  current  is  turned  off  and  the  instrument 
withdrawn.  The  operation  requires  five  minutes  to  execute. 


PRACTICAL    ELECTRO-THERAPEUTICS.  287 

The  patient  can  urinate  at  will  after  the  operation  and  can 
get  out  of  bed  in  a  few  days. 

The  operation  is  not  entirely  free  from  risk,  as  sepsis  may 
ensue.  The  operation  is  still  on  trial,  as  contractures  are 
liable  to  occur,  followed  by  stenosis,  and  render  a  subsequent 
prostatectomy  an  extremely  difficult  procedure. 


DISEASES  OF  THE  SKIN. 

Electricity  in  diseases  of  the  skin,  as  in  all  other  troubles, 
acts  either  as  a  stimulant,  a  tonic  or  a  sedative.  Galvanic 
electricity  is  of  far  more  value  than  either  tne)  faradic  or 
static,  singly  or  combined. 

As  a  sedative  galvanic  electricity  is  used  only  with  a  mild 
current  of  about  three  milliamperes  and  is  usually  applied 
for  about  five  minutes,  care  must  be  taken  that  the  current 
is  not  broken  during  the  application.  Galvanic  electricity 
possesses  the  power  of  improving  the  nutrition  of  the  skin 
and  thus  rendering  it  less  hospitable  to  many  forms  of 
organic  life,  and  thereby  tends  to  destroy  parasitic  diseases. 
Acne. — Electric  treatment  is  employed  rather  as  an 
adjuvant  to  general  and  local  treatment.  As  the  trouble 
undoubtedly  arises  from  faulty  elimination  the  organs  of 
elimination  must  be  stimulated.  The  following  prescription, 
taken  internally,  has  a  decided  beneficial  effect  on  the 
trouble: 

B  Citrate  Potass 1\ 

Liquor  Potass.  Arsenitis 3ii 

Glycerine §i 

Aqua   Menth.    pip.,   q.   s.   ad.   3iv 
Sig. — One  teaspoonful,  taken  three  times  a  day. 

Before  beginning  electrical  treatment  it  is  first  of  all 
necessary  to  empty  the  comedomes  of  their  inspissated 
sebum.  This  is  best  done  by  means  of  a  comedome  extractor. 
The  pustules  should  also  be  emptied  of  their  contents,  the 
entire  affected  area  washed  with  an  antiseptic  solution  and 
then  thoroughly  dried. 

The  positive  pole  of  the  galvanic  current  attached  to  a 
sponge  electrode  may  be  applied  over  the  surface  with  a  cur- 
rent strength  of  about  ten  milliamperes.  The  current  should 
be  allowed  to  pass  for  about  five  minutes. 

The  alternate  use  of  the  negative  and  positive  poles  are 
sometimes  productive  of  more  rapid  results  than  the  positive 
pole  used  alone. 

The  use  of  the  X-rays  in  acne  is  indicated  first,  because 

288 


PRACTICAL   ELECTRO-THERAPEUTICS.  289 


Faradic  Stimulation  to  Scalp. 

it  causes  an  atrophy  of  the  glands  of  the  skin,  the  sebaceous 
glands  as  well  as  the. hair  follicles;  and  secondly,  on  account 
of  its  bacteria-destroying  properties,  thus  inhibiting  the 
formation  of  pus. 

The  X-ray  should,  however,  not  be  used  until  all  other 
measures  have  been  tried  and  failed. 

Acne  Rosacea. — This  disease  may  be  treated  by  electrolysis 
of  the  capillary  blood-vessels,  with  the  positive  pole  at  some 
indifferent  place  and  the  negative  a  thin  needle  pushed  into 
a  dilated  blood-vessel.  Where  this  is  not  possible,  transfix 
the  blood-vessel  in  two  or  three  places.  A  current  from  a 
galvanic  battery  of  four  to  ten  cells,  with  a  strength  of  one 
to  three  milliamperes,  is  usually  sufficient.  The  electrolysis 
is  continued  until  the  blood-vessels  are  thoroughly  destroyed, 
and  no  bleeding  should  follow.  Three  or  four  punctures  or 
electro-punctures  are  sufficient  for  one  sitting,  and  the  pain 
on  introducing  the  needle  is  slight  when  no  current  is  pass- 
ing. The  treatment  may  have  to  be  carried  on  two  or 
three  times  a  week  for  five  or  six  months,  and  has  proved 
satisfactory  in  quite  a  number  of  cases. 

19 


290  PRACTICAL   ELECTRO-THERAPEUTICS. 

Alopecia, — There  is  no  doubt  of  the  efficacy  of  a  galvanic 
current  in  hastening  a  recovery  from  this  trouble.  A  large 
sponge  electrode  connected  with  the  negative  pole  with  a  cur- 
rent strength  of  six  milliamperes  may  be  applied  until  the 
scalp  turns  red. 

The  alternate  use  of  faradization  by  means  of  a  very  fine 
wire  brush  (bristles  as  fine  as  those  used  in  a  brush  for  silk 
hats)  acts  as  an  excellent  stimulant. 

Thorough  massage  of  the  scalp  by  means  of  electric  vi- 
brator may  also  help  to  revive  the  hairs  and  improve  their 
nourishment.  If  the  hair  roots,  however,  are  absolutely 
dead,  no  amount  of  treatment  will  revive  them. 

Callosities  of  the  skin,  caused  by  pressure,  etc.,  may  be 
softened  and  greatly  improved  by  means  of  the  galvanic 
negative  electricity,  and 

Carbuncles  may  be  aborted  in  their  incipiency  by  means  of 
the  electrolytic  needle  or. by  means  of  the  positive  galvanic 
current,  applied  for  about  twenty  minutes  with  a  strength  of 
about  twenty  milliamperes. 

Colasma,  or  the  abnormal  deposition  of  pigment  in  the 
skin,  is  frequently  benefited  by  the  use  of  galvanic  negative 
electricity. 

Eczema.^-In  this  multiform  disease  the  itching,  tingling 
and  burning  may  be  frequently  relieved  temporarily  by 
means  of  faradic  stimulation.  The  dry  form  responds  rapidly 
to  an  application  of  the  negative  electrode  to  the  parts,  the 
current  as  strong  as  can  be  borne  without  discomfort  to  the 
patient.  Apply  until  the  parts  are  thoroughly  reddened. 
Daily  sessions  are  best  and  frequently  bring  on  a  complete 
cure  in  chronic  cases.  The  positive  pole  applied  to  a  weeping 
eczema  may  be  equally  efficacious  by  removing  the  infiltra- 
tions from  the  surrounding  tissues.  In  the  moist  form, 
exposure  to  the  blue  light  has  in  the  author's  experience  been 
more  successful  than  any  form  of  electricity. 

Remarkable  results  are  being  claimed  for  the  X-ray 
therapy. 

Erysipelas. — Cataphoric  applications  of  various  dis- 
infectants may  be  tried  in  suitable  cases. 

Freckles. — The  negative  electric  needle  applied  to  the 
superficial  layers  of  the  skin  is  frequently  followed  by  a 
decided  effect  in  eliminating  the  discoloration. 

Herpes. — In    this    affection    the    positive   galvanic   pole 


PRACTICAL    ELECTRO-THERAPEUTICS.  291 

applied  near  the  periphery  of  the  nerve  for  ten  or  fifteen 
minutes  frequently  relieves  the  neuralgic  pains. 

Hypertrichosis. — For  the  removal  of  hair  a  very  fine  blunt- 
pointed  needle  is  used  with  a  current  of  one-half  *o  two 
milliamperes,  with  twenty-five  volts  or  less.  For  the  extrac- 
tion of  hair  a  low  voltage  is  used.  The  sensation  produced 
by  a  current  is  roughly  proportionate  to  the  voltage.  A 
small  current  with  a  high  voltage  is  intensely  painful,  as  is 
seen  in  static  electricity,  while  a  low  voltage  may  be  com- 
paratively painless.  From  four  to  ten  volts  will  do  for  small 
hairs  and  a  larger  voltage  for  large  coarse  h£,  'S,  in  the  less 
sensitive  part  of  the  skin.  ^ 

The  cells  of  the  batteries  are  connected  in  series,  the  carbon 
of  the  one  to  the  zinc  of  the  next.  Connect  the  electrodes 
and  test  the  current  by  taking  one  electrode  in  moistened 
fingers  and  touching  the  other  with  the  tip  of  the  tongue. 
Some  operators  insert  a  wire  from  a  positive  pole  in  a  glass 


Needle  Holder. 

of  water,  into  which  the  patient  puts  one  or  more  fingers  to 
complete  the  circuit.     Others  use  a  sponge  electrode. 

The  needle,  being  fastened  in  the  holder,  is  inserted  gently 
beside  the  hair.  The  needle  will  glide  gently  down  to  the 
root  of  the  hair  and  there  will  meet  with  slight  resistance. 
Instruct  the  patient  to  grasp  the  electrode  firmly.  Cease 
pressure,  and  in  ten  to  thirty  seconds  bubbles  of  hydrogen 
will  appear  around  the  needle.  If  the  hair  is  destroyed  it 
can  be  easily  removed.  The  current  must  not  be  turned  on 
before  the  needle  is  in  place,  nor  is  it  safe  to  extract  hairs 
that  are  close  together.  The  proper  method  is  to  go  over 
the  ground,  leaving  three  or  four  millimeters  between.  Not 
more  than  from  twenty  to  forty  hairs  should  be  removed  at 
one  sitting.  Begin  with  a  "mall  amount  of  current,  say  two 
or  three  cells,  and  increase  if  not  found  sufficient.  It  may 
be  well  to  have  two  different  colors  of  cords,  so  that  there 
will  be  no  confusion  between  the  positive  and  negative  elec- 


292  PRACTICAL    ELECTRO-THERAPEUTICS. 

trodes.  Unless  the  operator's  eyesight  is  good  a  magnifying 
glass  should  be  used. 

Hairs  that  were  less  noticeable  before  the  treatment  are 
sometimes  stimulated  to  growth  by  this  method  of  epilation, 
so  that  it  is  sometimes  necessary  to  go  over  the  area  several 
times. 

In  the  treatment  of  fine,  downy  hair,  treatment  by  elec- 
tricity seems  to  be  impracticable. 

As  shown  by  the  effects  of  X-rays  upon  the  hair  follicles, 
resulting  when  treating  other  pathological  conditions,  hair 
will  drop  out  in  from  four  to  eight  weeks  of  exposure.  The 
treatment  should  be  suspended  until  the  hair  begins  to  reap- 
pear, when  the  treatment  should  be  resumed  and  carried  on 
as  previously.  The  X-rays  are  not  advisable  except  in  cases 


Portable  Battery  for  Facial  Electrolysis. 

of  hypertrichosis  of  exaggerated  type.  The  greatest 
difficulty  in  connection  with  this  treatment  of  hypertrichosis 
is  that  one  must  cause  sufficient  atrophy  of  the  hair  follicles 
to  produce  alopecia  and  yet  do  it  without  causing  an  unde- 
sirable degree  of  dermatitis.  There  is  no  therapeutic  applica- 
tion of  the  X-rays  which  requires  so  much  caution  and  skill 
as  does  the  removal  of  hair,  and  should  only  be  undertaken 
after  one  has  had  considerable  experience  with  his  particular 
apparatus  in  the  treatment  of  other  affections. 

Lupus  Vulgaris. — May  be  treated  by  means  of  the  X-ray 
and  high  frequency  current  locally  applied,  but  responds 
almost  invariably  to  the  Finsen  Light  treatment. 

Pruritis,  being  a  neurosis  of  the  skin,  may  be  either  idio- 
pathic,  symptomatic  or  due  to  some  external  irritant.  It 
may  be  greatly  relieved  in  many  cases  by  means  of  galvanic 
electricity,  the  poles  being  placed  to  influence  the  nerve 


PRACTICAL    ELECTRO-THERAPEUTICS.  293 

( 

terminal.  Faradic  electricity  from  the  fine  wire  coil, may 
also  give  marked  relief,  so  also  may  a  few  exposures  to  the 
X-rays. 

Seborrhea. — The  negative  pole  of  the  galvanic  current 
with  a  moderately  strong  current  may  be  used  with  the 
sponge  electrode  over  site  of  the  disease. 

Sycosis. — Responds  favorably  to  the  treatment  of  X-rays 
and  the  high  frequency  currents.  Satisfactory  treatments 
are  usually  obtained  in  most  cases  within  a  month. 

Ringworm. — The  germicidal  action  of  copper  electrolysis 
is  a  specific  for  this  trouble.  The  copper  electrode  attached 
to  the  positive  pole  may  be  applied  directly  to  the  lesion,  after 
moistening  it  with  a  normal  salt  solution  to  insure  electrical 
contact.  A  current  strength  of  from  five  to  fifteen  milliam- 
peres  should  be  applied  until  the  parts  take  on  a  greenish 
appearance.  In  treating  ringworm  on  the  head  a  very  weak 
current  must  be  used  on  account  of  extreme  sensibility. 
Treatment,  of  necessity,  must  last  longer  than  when  applica- 
tion is  made  to  other  parts. 

Tattoo-marks  of  an  insoluble  pigment  may  be  removed  by 
means  of  electrolysis.  A  sharp-pointed  needle  connected  with 
the  negative  pole  of  a  galvanic  current  will  excite  sufficient 
inflammation  to  cause  the  pigment  to  be  thrown  off. 

Tinea. — The  cataphoric  action  of  electricity  may  be  made 
r.se  of  for  the  purpose  of  conveying  medicinal  substances  of 
an  antiseptic  nature  into  the  deeper  layers  of  the  skin, 
where  these  parasites  make  their  habitat. 

Chronic  ulcers  may  be  stimulated  to  assume  a  healthy 
condition  by  means  of  galvanic  electricity.  A  zinc  electrode 
connected  to  the  negative  pole  should  be  placed  over  the 
ulcer,  while  the  positive  may  be  placed  at  some  indifferent 
portion  of  the  body.  A  feeble  current  is  used  from  fifteen 
to  thirty  minutes, 

Antiseptics  such  as  copper  may  also  be  introduced  into  the 
ulcerating  tissues,  by  means  of  the  positive  pole,  and  thus 
bring  about  a  healthier  condition. 

Warts. — The  galvanic  current  with  the  positive  sponge 
electrode  with  a  current  of  from  four  to  six  milliamperes  is 
frequently  effective.  The  faradic  current  may  also  be  used; 
it  should  be  weak  at  first  and  gradually  made  as  strong  as  the 
patient  can  bear  it.  The  static  spark  applied  to  the  wart  is 
equally  effective.  If  the  wart  is  very  prominent  electrolysis 
as  in  naevus  or  the  galvanic  cautery  may  be  used. 


294  PRACTICAL    ELECTRO-THERAPEUTICS. 

Scars. — A  fine  needle  attached  to  the  negative  pole  of  the 
galvanic  battery  is  introduced  just  below  the  superficial  layer 
of  skin,  and  the  current  continued  long  enough  to  separate 
it  from  the  underlying  tissues.  Reinsert  needle  and  continue 
until  the  entire  surface  of  the  scar  has  been  acted  upon. 

Wounds. — Needle  pricks,  cuts  and  abrasions  of  the  surface 
may  be  readily  determined  by  placing  one  hand  in  a  basin 
of  water  in  which  one  of  the  poles  of  the  galvanic  battery 
is  placed.  A  smarting  or  burning  sensation  will  manifest 
itself  at  the  point  if  there  is  any  solution  of  continuity. 
This  is  of  advantage  to  a  physician  who  is  about  to  perform 
an  operation  upon  an  infected  surface,  enabling  him  to 
thoroughly  prepare  his  hands  b\-  protecting  the  abrasions. 

Angioma  or  ncrvi,  if  not  too  large,  may  be  destroyed  by 
means  of  electrolysis.  The  main  thing  to  be  obtained  is  the 
complete  destruction  of  the  vascular  tissue  and  the  ultimate 
shutting 'off  of  the  blood  supply  to  the  part.  The  galvanic 
current  accomplishes  this  by  using  the  positive  electrode. 
Use  a  limited  area  and  repeat  at  frequent  intervals. 

Needles  set  in  a  brass  disk  one  or  two  millimeters  apart 
comprise  the  proper  electrode  for  treating  naevi.  The 
needles  must  be  exceedingly  fine  and  have  very  sharp  points. 
When  the  skin  around  the  needles  begins  to  blanch  and  rise 
in  wheals  galvanic  action  is  established.  In  twenty-four 
to  thirty-six  hours  small  crusts  will  form,  and  when 
these  fall  off  small  cicatrices  will  show  themselves.  The 
operation  may  be  repeated  every  two  weeks  until  the. color 
is  approximately  normal. 

In  occluding  veins  care  must  be  taken  not  to  withdraw  the 
needle  until  the  clot  is  firmly  fixed,  otherwise  the  clot  may 
become  an  embolus  and  cause  any  amount  of  mischief. 

When  desired  needles  connected  with  both  poles  may  be 
introduced  into  the  growths  parallel  to  each  other,  one  being 
positive  and  the  other  negative.  The  current  is  turned  on 
until  the  tissues  are  blanched  and  the  froth  around  the  needle 
indicates  a  rapid  destruction  of  tissue.  Electrolysis  must 
be  continued  until  no  hemorrhage  takes  place  on  the  removal 
of  the  needle,  and  as  much  of  the  growth  may  be  destroyed 
at  one  sitting  as  possible.  The  strength  of  the  current  is 
indicated  by  the  patient  s  endurance,  the  pain  being  very 
intense  at  times,  but  usually  ceases  on  the  removal  of  the 
needle.  The  scar  following  galvano-cautery  is  much  more 
marked  than  when  electrolysis  is  used. 


MISCELLANEOUS. 

NEPHRITIS. 

Whatever  the  cause  of  this  disease,  it  may  be  presumed 
that  there  is  some  inherent  or  acquired  weakness  of  the 
kidneys  present,  rendering  them  the  weak  link  in  the  visceral 
chain,  and  that  this  is  the  real  cause  why  they  fall  victims 
to  the  various  causes  ascribed  as  the  active  agents  in  pro- 
ducing this  disease.  In  many  cases  lesions  of  the  spine,  of 
such  a  nature  as  to  interfere  with  the  vital  forces  distributed 
to  the  kidneys,  are  present.  This  explains  why  the'  poisons 
of  acute  infectious  diseases  frequently  produce  nephritis 
in  an  already  weakened  urinary  mechanism,  and  why  one 
person  suffers  from  the  disease,  while  similar  circumstances 
fail  to  cause  it  in  another. 

Owing  to  the  serious  pathological  changes  that  have  taken 
place  before  the  patient  consults  a  physician,  the  treatment 
is  directed  largely  to  the  alleviation  of  the  manifestations 
of  the  disease,  such  as  nausea,  vomiting,  headache,  pain  in 
the  back,  dropsy,  etc.  It  is  necessary  for  the  relief  of  the 
symptoms  to  rid  the  system  of  the  accumulated  poisons. 
As  the  visceral  organs  are  usually  in  a  congested  condition 
and  frequently  fail  to  respond  to  diuretics,  etc.,  recourse 
should  always  be  had  to  either  hot  air  or  electric  light  baths, 
which  give  relief  to  the  kidneys,  liver  and  heart.  In  many 
cases  where  the  first  sound  of  the  heart  at  the  base  can  not 
even  be  heard,  ten  to  fifteen  minutes  in  the  electric  light  bath 
will  make  it  almost  as  plainly  distinguishable  as  the  second 
sound,  whose  ringing  character  is  also  greatly  modified.  The 
effect  frequently  lasts  for  hours,  and  where  treatment  is  per- 
sisted in  daily,  for  a  long  time,  the  apex  beat,  which  is 
outside  of  the  nipple  line,  may  be  brought  back  almost  to  its 
normal  position. 

Vibratory  stimulation  of  the  entire  spine  is  indicated,  as 
the  vicious  circle,  once  established,  involves  all  the  organs. 

The  high  frequency  current,  on  account  of  the  large 
amount  of  ozone  developed,  is  a  great  aid  in  treating  this 
disease.  Treatment  should  be  given  to  the  entire  body  for 
an  hour,  several  times  a  day  if  necessary,  in  severe  cases. 

295 


296  PRACTICAL    ELECTRO-THERAPEUTICS. 

The  wave  current  with  the  electrode  over  the  liver,  kidneys 
and  spine,  with  a  spark-gap  of  five  to  six  inches,  for  one- 
half  hour  daily,  as  well  as  the  static  bath,  may  be  given  with 
a  great  deal  of  benefit. 

DIABETES. 

The  influence  of  the  general  nervous  system  in  diabetes  is 
well  known,  but  not  understood.  Lesions  in  the  medulla, 
cord  and  sympathetic  system  have  caused  diabetes.  In  the 
floor  of  the  fourth  ventricle  lies  the  so-called  diabetes  center. 
It  is  a  point  puncture  of  which  results  in  diabetes.  The 
effect  is  doubtless  gotten  through  the  vagi  nerves  which 
originate  from  this  point.  The  vagi  also  participate  in 
liver  function. 

Treatment. — Stimulate  the  cervical  spinal  centers,  solar 
plexus,  splanchnic  and  lumbar  region,  restoring  the  func- 
tion of  the  pancreas,  liver  and  small  intestines.  Apply  the 
wave  current  with  the  electrode  over  liver.  The  pain  in 
the  hepatic  region  is  usually  relieved  almost  instantly  by 
application  of  the  negative  spray  to  this  region.  The  head 
breeze  usually  relieves  the  headache  and  dizziness.  Electric 
light  baths  will  hasten  elimination  and  oxidation  of  waste. 
The  high  frequency  current  is  also  a  great  aid  in  hastening 
oxidation  of  tissue  waste. 

AUTO-INTOXICATION. 

In  the  course  of  all  diseases  we  find  nature  trying  to  dis- 
pose of  the  deleterious  or  poisonous  products  by  means 
of  elimination,  and  anything  that  will  assist  in  the  removal 
and  oxidation  of  this  waste  material  will  help  to  relieve 
the  diseased  condition. 

The  elimination  of  waste  is  most  easily  accomplished  by 
means  of  the  hot  air  bath,  which  causes  elimination  of  waste 
through  the  skin,  causes  ingestion  of  water  in  abundant 
amount  and  at  the -same  time  permits  absorption  through 
the  mucous  surfaces,  subjecting  the  tissues  to  a  veritable 
water  bath. 

Anything  that  will  assist  in  the  oxidation  of  the  waste 
material  present  in  the  body  will  hasten  a  cure  in  the  dis- 
eased condition.  Hence  the  wave  current  with  the  electrode 
over  the  liver  or  organ  involved,  and  positive  insulations 


PRACTICAL    ELECTRO-THERAPEUTICS. 


297 


Wave  Current  in  Diabetes,  Electrode  Over  Liver  and  Interrupted 
Breeze  to  Forehead. 

will  be  most  effective.  Friction  sparks  over  the  entire  body 
will  also  be  a  great  aid  by  stimulating  the  integumental 
tissues  to  empty  their  waste  into  the  general  circulation. 

When  the  heart  is  involved,  positive  insulation,  with  the 
active  pole  over  the  heart,  is  frequently  very  effective. 

The  entire  lymphatic  system  needs  stimulation,  and  this 
may  be  secured  by  stimulation  of  the  trophic  nerves  which 
supply  the  glands  draining  the  infected  areas. 

HEPATITIS. 

Repeated  attacks  of  congestion,  if  not  relieved,  will 
cause  atrophy  or  cirrhosis  of  the  liver.  After  exhausting 
fevers  there  frequently  remains  an  impaired  condition  of 
the  general  system.  The  weak  and  irritable  heart  usually 
present  in  these  disorders  frequently  keeps  up  a  chronic 
state  of  engorgement  of  the  liver. 

Faradic  stimulation  and.  static    electricity    act    in    some 


298  PRACTICAL    ELECTRO-TIIERArEUTICS. 

degree  as  a  substitute  for  active  exercise,  and  frequently 
bring  speedy  relief  and  even  complete  recovery  where  other 
methods  have  failed. 

A  powerful  effect  may  frequently  be  had  on  the  sympathetic 
system  by  these  currents,  affecting  the  heart  itself  as  well  as 
the  arterial  ramifications  in  the  liver.  In  using  the  faradic 
.current  apply  one  pole  at  the  cilio-spinal  center  and  the 
other  at  the  feet  or  the  buttocks  or  the  solar  plexus.  Elec- 
tricity is  of  little  value  as  long  as  disregard  for  hygienic 
methods  of  living  exists. 

Enlargement  of  the  liver  may  follow  as  the  result  of  an 
enlarged  spleen,  frequently  depending  on  a  loss  of  its  con- 
tractility, followed  by  a  subsequent  retention  of  its  contents. 
Where  faradization  and  static  electricity  have  failed  the 
galvanic  current  is  frequently  of  benefit. 

In  cirrhosis  of  the  liver  the  pains  are  frequently  tempo- 
rarily relieved  by  electricity,  which  also  keeps  in  subjection 
the  ascites  and  edematous  condition  of  the  legs. 

Jaundice,  being  merely  a  symptom,  frequently  yields  to 
electricity  if  not  due  to  obstruction  of  gall-duct. 

It  is  frequently  difficult  to  determine  the  exact  measure  of 
benefit  derived  from  any  special  method  of  treatment  when 
it  is  only  one  of  a  number  of  others  that  are  simultaneously 
in  use. 

RHEUMATISM. 

In  rheumatism  of  special  groups  of  muscles,  the  source  of 
the  discomfort  is  frequently  found  in  the  origin  of  the  nerve 
supplying  them.  This  is  also  true  in  chronic  articular 
rheumatism,  and  the  nerve  supply  of  the  limbs  is  almost 
always  obstructed.  The  obstruction  may  be  at  the  exact 
locality  of  the  pain,  or  in  the  course,  or  at  the  origin  of  the 
nerve  supplying  the  part. 

In  lumbago  there  is  almost  invariably  some  irritation  of 
the  nerve  fibers  supplying  the  muscle  bundles  of  the  erector 
spinse.  The  causative  agent  of  rheumatism  acts  by  derang- 
ing the  blood  and  nerve  supply  locally  or  generally.  In 
inflammatory  rheumatism  the  effect  is  possibly  an  infection, 
acting  on  the  system  through  causes  which  derange  the  func- 
tions of  the  liver  and  kidney  and  also  of  the  central  nervous 
system. 

The  treatment  consists  principally  in  treating  the  primary 


PRACTICAL    ELECTRO-THERAPEUTICS.  299 

cause,  looking  particularly  to  the  excretion  of  the  poisons 
from  the  system.  The  circulation  to  the  part  affected  must 
be  kept  free. 

This  is  accomplished  by  vibratory  stimulation  along  the 
entire  spine,  and  especially  the  tender  spots,  if  any  are 
present.  Stimulation  must  also  be  employed  along  the  vessels 
and  lymphatics  of  the  part  affected.  Remove  the  muscular 
contractures  wherever  present. 

Muscular  rheumatism  is  usually  obedient,  in  a  very  marked 
degree,  to  some  form  of  electricity.  Static  electricity  is 
found  the  most  efficacious  in  muscular  rheumatism.  It  is 
by  no  means  a  pleasant  method  of  procedure,  but  if  continued 
for  from  twenty  minutes  to  a  half  hour,  sufferings  of  weeks 
from  attacks  of  lumbago,  etc.,  have  been  completely  cured 
after  a  single  treatment. 

Where  the  pain  is  of  a  neuralgic  type,  with  great  tenderness 
on  pressure,  galvanic  and  faradic  electricity  are  preferable, 
and  one  treatment  will  almost  immediately  lessen  the  tender- 
ness and  relieve  the  pain. 

Acute  Rheumatism. — The  static  brush  discharge  or  high 
frequency  current  for  twenty  to  forty  minutes  over  the  seat 
of  inflammation  frequently  relieves  the  swelling  and  improves 
metabolism  in  acute  rheumatism. 

Local  applications  of  methyl  salicylate,  the  affected  part 
being  afterward  covered  with  flannel,  are  made  very  effective 
by  static  friction  sparks  which  hasten  absorption  and  im- 
prove the  circulation. 

There  are  some  persons  who  are  born  not  to  be  treated  by 
electricity,  while  there  are  others  who  are  more  susceptible 
and  respond  more  kindly  to  any  form  of  judicious  electric 
application.  General  faradization  is  frequently  followed  by 
a  marked  alleviation  of  pain  and  the  shortening  of  an  attack. 

In  articular  rheumatism  the  wave  current  over  the  liver 
and  kidney  will  stimulate  these  organs  to  activity.  This 
current  may  be  applied  over  the  affected  joint  with  a  spark- 
gap  of  from  six  to  ten  inches,  or  as  long  as  it  can  be  borne 
without  causing  painful  contractions,  about  fifteen  or  twenty 
minutes. 

Hot  air  or  electric  light  baths  (local  or  general  as  indicated) 
are  important  aids  in  eliminating  the  poison.  If  cold  is 
applied  after  the  bath  it  must  not  be  too  prolonged  or  too 
intense,  as  cold  water  flowing  directly  on  the  joints  may 
increase  the  pain. 

18 


300  PRACTICAL    ELECTRO-THERAPEUTICS. 

As  it  is  of  importance  to  increase  the  nutrition  of  the 
parts,  the  trophic  centers  in  the  spine  must  be  actively 
stimulated. 

RHEUMATOID  ARTHRITIS. 

Electricity  has  been  found  to  be  a  palliative  to  a  marked 
degree  in  many  cases,  relieving  pain  and  increasing  mobility. 
The  static-induced  current,  with  the  high  tension,  is  often 
very  serviceable,  as  well  as  the  high  tension  faradic 
current,  and  a  vigorous  current  sufficient  to  produce  intense 
redness  of  the  skin  is  sometimes  followed  by  great  relief. 

When  we  wish  to  give  the  entire  body  the  effect  of  galvanic 
or  faradic  stimulation  or  sedation  there  is  no  mode  of  treat- 
ment so  well  adapted  to  do  so  as  the  electric  bath. 

SCOLIOSIS. 

Spinal  curvatures  are  rarely  painful,  but  when  pain  is 
present,  the  first  step  in  the  treatment  is  to  carefully  relax  all 
spinal  tissues,  deep  and  superficial;  to  increase  or  correct 
the  circulation  in  them. 

Treatment — Vibration — Treat  with  moderately  deep  pres- 
sure on  the  side  toward  the  deviation  to  relax  the  contracted 
muscles,  thereby  removing  the  irritation  to  the  nerves  con- 
sequent on  contracture.  Next,  treat  the  opposite  side  of  the 
spinal  column  to  increase  the  blood  -supply  to  the  nerves  of 
nutrition.  This  will  materially  aid  in  developing  tone  and 
strength  in  partially  inhibited  muscles. 

It  is  a  good  rule  in  spinal  curvature  to  direct  attention  to 
replacement  of  the  parts  affected.  Begin  at  the  lowest 
vertebra  involved  and  make  an  attempt  at  each  treatment 
to  replace  it.  A  considerable  degree  of  force  is  sometimes 
necessary  to  put  the  parts  back  into  place,  but  violence  must 
be  avoided.  Wave  current  to  the  spine  is  a  great  aid  in 
improving  the  circulation  and  tone  of  the  muscles. 

CONTRACTURES,  TORTICOLLIS, ETC. 

Whenever  an  inflammatory  process  continues  for  a  length 
of  time  in  the  structures  of  a  movable  joint  in  any  part  of 
the  body,  the  group  of  muscles  which  control  the  action  of 
that  joint  become  contracted  and  the  limb  becomes  fixed  in 
extension  or  flexion,  because  long-continued  irritation  of  the 


PRACTICAL    ELECTRO-THERAPEUTICS.  301 

nerves  induces  contraction  of  the  muscular  fibers.  Sparks 
liberally  applied  along  the  course  of  the  contracted  muscles 
serve  better  than  any  other  means  to  overcome  muscular  con- 
tractions. Contracture  may  be  prevented  in  paralyzed  limb, 
if  treatment  is  instituted  while  the  muscles  may  still  be 
extended  by  gentle  manipulation  and  muscular  shortening 
is  not  yet  established.  The  wave  current  from  the  static 
machine,  as  strong  as  can  be  given  without  causing  painful 
muscular  contractions,  is  also  useful,  though  not  so  effect- 
ive as  sparks. 

SPRAINS  AND  BRUISES. 

If  the  incandescent  blue  light  be  used  shortly  after  the 
injury,  sprains  or  muscular  ruptures  are  greatly  modified, 
as  swelling  is  prevented  and  pain  averted. 

Massage  and  vibration  of  the  affected  parts  is  also  very 
effective,  as  it  removes  the  stagnant  condition  in  blood  and 
lymph  systems.  Look  well  to  the  glands  draining  this  area. 

Local  light  baths  will  aid  the  disappearance  of  the  swelling 
in  a  comparatively  short  time.  The  static  wave  current, 
short  sparks  and  Leyden  jar  currents  are  also  great  aids  in 
improving  the  nutrition  in  the  parts. 

In  the  treatment  of  fractures  the  static  spray  or  brush 
discharge  will  allay  the  suffering  of  the  patient  and  hasten 
the  complete  recovery  of  the  case.  Sparks  are  not  indicated, 
as  the  active  contraction  of  the  muscles  before  the  bones  are 
united  would  be  apt  to  throw  the  parts  out  of  position. 

The  danger  of  anchylosis  is  greatly  lessened,  due  to  the 
diminished  congestion  and  more  rapid  repair  of  the  injured 
parts. 

SYNOVITIS 

when  not  characterized  by  pus  may  be  treated  by  means  of 
the  static  wave  current,  spark  or  spray.  Long  percussion 
sparks  are  imperative  in  many-cases  to  bring  about  a  cure. 
Exposure  to  the  blue  light  alone  for  thirty  to  fifty  minutes 
has  been  followed  by  success  in  several  of  the  author's  cases. 

GOITER. 

The  positive  sponge  electrode  with  galvanic  current  may 
be  applied  to  the  surface.  A  large  electrode  should  be  used 
to  permit  a  considerable  current  strength  (five  to  ten  milli- 

l'-  h 


302  PRACTICAL   ELECTRO-THERAPEUTICS. 

amperes).  Treatments  should  be  repeated  every  second  day. 
The  dispersing  electrode  may  be  held  on  the  back.  Cata- 
phoresis  may  also  be  used,  a  solution  of  iodide  of  potassium 
being  applied  by  means  of  a  large  electrode,  the  negative 
pole  being  used  over  the  gland. 

Hypodermic  injections  of  dilute  Lugol's  solution  may  be 
diffused  throughout  the  tissues  by  leaving  the  needle  in  place 
and  using  it  as  the  negative  electrode. 

In  the  cystic  form  of  goiter,  electrolysis  should  be  given 
the  preference.  The  cyst,  being  emptied,  is  filled  with  a 
normal  salt  solution  and  the  negative  needle  introduced,  a 
current  strength  of  twenty  milliamperes  being  passed  for 
twenty  minutes. 

'ANEURISMS 

of  large  blood-vessels  offer,  as  a  rule,  a  hopeless  prognosis, 
and  until  anodal  or  positive  electrolysis  was  employed,  little 
hope  of  even  amelioration  could  be  held  out  for  any.  Skilled 
operators  have  succeeded  by  inserting  a  spiral  coiled  fine 
gold  wire  into  the  aneurismal  sac  through  an  aspirating 
needle.  This  wire  is  then  made  the  anode,  or  positive  pole, 
of  a  direct  current  of  from  ten  to  one  hundred  milliamperes. 
The  cathode,  or  negative  pole,  being  placed  on  some  conven- 
ient part  of  the  body,  the  current  is  continued  until  pulsation 
ceases  and  evidence  is  given  that  coagulation  and  solidifica- 
tion have  taken  place,  which  may  require  from  ten  minutes 
to  an  hour  or  more. 

In  some  instances  several  coils  of  fine  wire  have  been 
inserted  at  different  points  of  the  dilated  vessel  at  the  same 
sitting.  Considering  the  inevitably  fatal  ending  of  these 
cases,  if  not  interfered  with,  the  operation  is  justified  in 
suitable  cases,  as  a  sufficiently  large  proportion  find  marked 
relief  and  life  is  prolonged. 

TUBERCULAR  GLANDS. 

Zinc  cataphoresis  may  be  used  when  the  infected  area 
is  limited. 

After  anesthetizing  the  parts  to  be  treated  (which  may  be 
done  by  means  of  an  ethyl  chloride  spray),  a  puncture  is  made 
by  means  of  a  Hagedorn  needle.  To  permit  the  introduction 
of  the  needle  electrode  a  drop  of  cocaine  placed  about  the 


PRACTICAL   ELECTRO-THERAPEUTICS.  303 

end  of  the  needle  will  make  the  anesthetic  effect  more  perma- 
nent. 

The  negative  electrode  may  be  placed  over  the  back  or 
abdomen  and  a  current  of  from  one-half  to  four  milliamperes 
passed  through  the  parts  for  about  fifteen  minutes.  As  a 
rule  only  one  gland  is  treated  at  a  time,  applications  being 
made  every  few  days.  The  treatment  may  require  months, 
but  when  cured  no  ugly  scars  will  be  found,  as  in  cases  where 
the  glands  have  been  removed. 


INDEX. 


PACE 

Acne 288 

Alimentary  Tract 253 

Alopecia  204,  290 

Alternating  Current  Couch 123 

Ampere — Definition    15 

Amenorrhea 271 

Aneurism    302 

Angina  Pectoris 262 

Angioma 294 

Ani — Prolapsus 257 

Anodal  Electrolysis 29 

Anode — Definition  of • 22 

Arc  Lamp  202 

Arthritis    300 

Asphyxia 262 

Asthma 261 

Atrophic  Paralysis 238 

Auto-intoxication    296 

Baths— Arc  Light 215 

Electric 53 

Incandescent  Light 212 

Battery  Solution 11 

Bipolar  Electrode 266 

Method  of  Faradization 266 

Blue  Light  Treatment 205 

Brain — Perverted  Functioning  of 239 

Callosities 290 

Carbuncles 290 

Cancer '. 147 

Cataphoresis 31 

Anodal  Electrolysis 29 

Cathodal  Electrolysis 29 

Electro  Cataphoric  Bath 53 

Local  Anesthesia   31 

Mercuric 32 

Cocaine  31 

Aconite 31 

Iodine 31 

Cathode — Definition 22 

Cells— Arrangement 12 

Central  Galvanization 241 

Chemical  Effect  of  Poles 27 

Chorea  247 

Coccygodinia 246 

Coil  Currents— Physiology  of 43 

304 


INDEX.  305 

PAGE 

Colasma 290 

Conjunctivitis    87 

Constipation •. •  256 

Contraction — Anodic  Break '. 229 

Anodic  Make 229 

Cathodic  Break 228 

Cathodic  Make 228 

Contractures 300 

Current  Diffusion 22 

Current  Flow 12 

Cystitis 284 

Dermatitis— X-Ray .- 148 

Diabetes 29(i 

Diaphragm  Paralysis 251 

Diarrhea    ' •. 257 

Diphtheria— Paralysis  of 235 

Dysmenorrhea 268 

Ectopic  Gestation 277 

Eczema 290 

Electric  Bath : 53 

Electrodes 9-22 

Electro-diagnosis 221 

Electrolysis 26 

Electrolyte   10 

Eneuresis    284 

Epithelioma 149 

Erysipelas ." 290 

Exophthalmic  Goiter 246 

Facial  Paralysis ] 238 

Faradic  Current 38 

Faradic  Brush 49 

Fibroids  of  Uterus ..-.-.•.-.•. 278 

Fissures 258 

Fluoroscope 131 

Freckles -. 290 

Galvanic  Current — Physiology  of 23 

Sedation .••.•.-.•  •  • 35 

Stimulation 35 

Galvano-Cautery •. 59 

Galvano-Faradic  Current. 52 

Galvano-Puncture    279 

Gleet 283 

Goiter 301 

Hallucinations .- 242 

Headaches 243 

Hematosalpinx 277 

Hemiplegia 243 

Hemorrhoids 257 

Hepatitis 297 

Herpes  290. 

Hiccough 253 

High  Frequency  Currents '. Ill 

20 


306  INDEX. 

PAGE 

Hydrosalpinx 277 

Hughes  Ionizer 93 

Hydrocele 285 

Hypertrichosis    291 

Hysteria 247 

Illumination 64 

Impotency '. 284 

Induced  Current .• 38 

Infantile  Paralysis 232 

Insomnia 249 

Intercostal  Neuralgia   246 

Iodine  Cataphoresis      31 

Jaundice 298 

Laryngitis,  Chronic 106 

Lead  Poisoning 252 

Leyden  Jars    69 

Leyden  Jar  Currents  107 

Light,  Physiology  of .' 197 

Therapeutic  Employment  of 203 

Liver 297 

Locomotor  Ataxia 108,  248 

Lumbago 95 

Lupus  Vulgaris  292 

Magnet 62 

Measurements  15 

Menopause  278 

Metrorrhagia 271 

Mental  Disorders 241 

Menstruation 268 

Mercuric  Cataphoresis 

Metritis 275 

Milliamperemeter 16 

Naevus 204 

Neuralgia 244 

Nephritis 

Neurasthenia 55 

Occupation  Neuroses 108,  248 

Esophagus — Stricture  of 253 

Ohm's  Law , 16 

Ovarian  Congestion    269 

Neuralgia 270 

Ovaritis 270 

Paralysis — Atrophic   238 

of  Diaphragm 251 

Diphtheritic .' 235 

Facial 238 

Lead    252 

Pelvic  Disorders 264 

Penetrometer 1 

Pharyngitis 1 

Poliomyelitis — Acute 234 

Post-partum  Hemorrhage 277 


INDEX.  307 

PAGE 

Prolapsus  Ani  257 

Prostatitis 285 

Pruritis   292 

Pyosalpinx 277 

Psychic  Disorders 243 

Rheostat 17 

Rheotome 18 

Rheumatism 55,  107,  298 

Roentgen  Rays 125 

Rhinitis 57,  259 

Ruhmkorff's  Induction  Coil 126 

Salpingitis 276 

Sciatica    245 

Scoliosis 300 

Seborrhea  293 

Sinusoidal  Currents 65 

Solenoid,  Auto-induction. 114 

Alternating  Current 122 

Spinal  Disorders 230 

Static  Electricity 67 

Apparatus,  Care  of 76 

Physiology  of  70 

Static  Electricity,  Modes  of  Application- 
Insulation  83 

Breeze 85 

Spray 87 

Spark 94 

Wave  Current 101 

Leyden  Jars  107 

Sterility 277 

Stricture  of  Esophagus 253 

Rectum 258 

Urethra 281 

Stomach— Atony 253 

Dilated 255 

Hyperesthesia 253 

Subinvolution 272 

Sycosis 293 

Synovitis  301 

Tattoo  Mark 293 

Tinea 293 

Tinnitus  Aurium 259 

Tonsillitis 260 

Torticollis 300 

Trauma 239 

Tracheotomy 260 

Tuberculosis   83 

Tubercular  Laryngitis    260 

Glands 302 

Ulcers,  Chronic 293 

Urethritis 56 

Urethra,  Stricture  of 281 


308  INDEX. 


Uterus,  Infantile 267 

Displacement 273 

Metritis 275 

Endometritis 274 

Cervical  Endometritis 274 

Catarrhal  Salpingitis 276 

Septic  Endometritis 275 

Senile  Endometritis 275 

Post-partum  Hemorrhage 277 

Fibroids  of .' 278 

Vancocele 285 

Vesical  Spasm 283 

Voltage,  Definition  of 15 

Voltaic  Cell 9 

Vomiting  of  Pregnancy 277 

Warts  293 

Wounds,  Detection  of 2<>4 

Vibratory  Stimulation 151 

Table  for 196 

X-Rays— Apparatus 125 

Tubes 132 

Aid  in  Differential  Diagnosis    . 

Vocalization  of  Fractures  and  Dislocations 136 

Therapy  144 


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